Provider Demographics
NPI:1457920365
Name:ROBINSON, CAMILLE SHAINA
Entity type:Individual
Prefix:
First Name:CAMILLE
Middle Name:SHAINA
Last Name:ROBINSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4235 N UNIVERSITY DR APT 107
Mailing Address - Street 2:
Mailing Address - City:SUNRISE
Mailing Address - State:FL
Mailing Address - Zip Code:33351-6216
Mailing Address - Country:US
Mailing Address - Phone:954-393-5608
Mailing Address - Fax:
Practice Address - Street 1:4235 N UNIVERSITY DR APT 107
Practice Address - Street 2:
Practice Address - City:SUNRISE
Practice Address - State:FL
Practice Address - Zip Code:33351-6216
Practice Address - Country:US
Practice Address - Phone:954-393-5608
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-24
Last Update Date:2021-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL87-1231707Medicaid