Provider Demographics
NPI:1417793902
Name:KREMER, CAMILA (RD)
Entity type:Individual
Prefix:
First Name:CAMILA
Middle Name:
Last Name:KREMER
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:CAMILA
Other - Middle Name:
Other - Last Name:MILLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RD
Mailing Address - Street 1:7095 POND CYPRESS CT APT 201
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34109-7860
Mailing Address - Country:US
Mailing Address - Phone:239-298-6333
Mailing Address - Fax:
Practice Address - Street 1:2840 JACKSON AVE APT 16M
Practice Address - Street 2:
Practice Address - City:LONG ISLAND CITY
Practice Address - State:NY
Practice Address - Zip Code:11101-3350
Practice Address - Country:US
Practice Address - Phone:239-298-6333
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-03
Last Update Date:2024-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY011999133V00000X
FL6101-73669133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered