Provider Demographics
NPI:1730178955
Name:CAMBA, VICTORIA A (DO)
Entity type:Individual
Prefix:
First Name:VICTORIA
Middle Name:A
Last Name:CAMBA
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2200 NE 15TH TER
Mailing Address - Street 2:
Mailing Address - City:WILTON MANORS
Mailing Address - State:FL
Mailing Address - Zip Code:33305-2315
Mailing Address - Country:US
Mailing Address - Phone:954-565-6739
Mailing Address - Fax:
Practice Address - Street 1:2200 NE 15TH TER
Practice Address - Street 2:
Practice Address - City:WILTON MANORS
Practice Address - State:FL
Practice Address - Zip Code:33305-2315
Practice Address - Country:US
Practice Address - Phone:954-565-6739
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-10-20
Last Update Date:2023-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS8584207P00000X
KY05405207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
P00451233OtherRR MCR
FL15350OtherBCBS
FL264081300Medicaid
FL15350WMedicare PIN
P00451233OtherRR MCR