Provider Demographics
NPI:1366925364
Name:CAMBAS, JAYNE (BAS CCS)
Entity type:Individual
Prefix:
First Name:JAYNE
Middle Name:
Last Name:CAMBAS
Suffix:
Gender:F
Credentials:BAS CCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:514 NE 166TH ST
Mailing Address - Street 2:
Mailing Address - City:NORTH MIAMI BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33162-3562
Mailing Address - Country:US
Mailing Address - Phone:786-400-8042
Mailing Address - Fax:
Practice Address - Street 1:514 NE 166TH ST
Practice Address - Street 2:
Practice Address - City:NORTH MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33162-3562
Practice Address - Country:US
Practice Address - Phone:786-400-8042
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-14
Last Update Date:2020-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL171W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor