Provider Demographics
NPI:1588411847
Name:LEVRAN, CAMILLA
Entity type:Individual
Prefix:MRS
First Name:CAMILLA
Middle Name:
Last Name:LEVRAN
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 1:9802 PEPPER TREE TER APT 208
Mailing Address - Street 2:
Mailing Address - City:WILDWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:34785-7559
Mailing Address - Country:US
Mailing Address - Phone:973-727-3735
Mailing Address - Fax:
Practice Address - Street 1:619 W DIXIE AVE
Practice Address - Street 2:
Practice Address - City:LEESBURG
Practice Address - State:FL
Practice Address - Zip Code:34748-2602
Practice Address - Country:US
Practice Address - Phone:352-805-4404
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-03
Last Update Date:2024-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLS162112355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant