Provider Demographics
NPI:1932723293
Name:GO, CAMILLE CELESTE (MD)
Entity type:Individual
Prefix:DR
First Name:CAMILLE CELESTE
Middle Name:
Last Name:GO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14232 SW 163RD ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33177-1813
Mailing Address - Country:US
Mailing Address - Phone:786-654-9138
Mailing Address - Fax:
Practice Address - Street 1:1475 W 49TH ST
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33012-3222
Practice Address - Country:US
Practice Address - Phone:305-558-2500
Practice Address - Fax:305-816-1925
Is Sole Proprietor?:No
Enumeration Date:2020-06-02
Last Update Date:2022-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME158048207Q00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program