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Individual

JOHNNY CAMILLE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
2450 BATES AVE SW, WINTER HAVEN, FL 33880-2448
(863) 877-6041
Mailing address
2450 BATES AVE SW, WINTER HAVEN, FL 33880-2448
(863) 877-6041

Taxonomy

Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
238688
FL
374U00000X
Home Health Aide
238688
FL

Other

Enumeration date
07/05/2023
Last updated
08/11/2023
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