Provider Demographics
NPI:1154622736
Name:CAMERON, GERALDINE YVETTE (REGISTERED NURSE)
Entity type:Individual
Prefix:
First Name:GERALDINE
Middle Name:YVETTE
Last Name:CAMERON
Suffix:
Gender:F
Credentials:REGISTERED NURSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14527 BROADHAVEN BLVD
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32828-7690
Mailing Address - Country:US
Mailing Address - Phone:407-925-8206
Mailing Address - Fax:
Practice Address - Street 1:14527 BROADHAVEN BLVD
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32828-7690
Practice Address - Country:US
Practice Address - Phone:407-925-8206
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-12
Last Update Date:2010-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN9307135163W00000X
NY5208351163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse