Provider Demographics
NPI:1174735971
Name:ARBOLEDA, CAMILO (LMT, CCPA)
Entity type:Individual
Prefix:
First Name:CAMILO
Middle Name:
Last Name:ARBOLEDA
Suffix:
Gender:M
Credentials:LMT, CCPA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8204 CRYSTAL CLEAR LN
Mailing Address - Street 2:SUITE 1500
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32809-7758
Mailing Address - Country:US
Mailing Address - Phone:407-240-8884
Mailing Address - Fax:407-240-8883
Practice Address - Street 1:8204 CRYSTAL CLEAR LN
Practice Address - Street 2:SUITE 1500
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32809-7758
Practice Address - Country:US
Practice Address - Phone:407-240-8884
Practice Address - Fax:407-240-8883
Is Sole Proprietor?:No
Enumeration Date:2007-05-04
Last Update Date:2013-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA33687174400000X
FLCI 382247200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other
No174400000XOther Service ProvidersSpecialist