Provider Demographics
NPI:1801789979
Name:CHAUX-MANTILLA, CAMILA (APRN)
Entity type:Individual
Prefix:
First Name:CAMILA
Middle Name:
Last Name:CHAUX-MANTILLA
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:CAMILA
Other - Middle Name:STEPHANIE
Other - Last Name:CHAUX
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:15409 SW 50TH LN
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33185-4403
Mailing Address - Country:US
Mailing Address - Phone:786-413-8139
Mailing Address - Fax:
Practice Address - Street 1:15409 SW 50TH LN
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33185-4403
Practice Address - Country:US
Practice Address - Phone:786-413-8139
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-29
Last Update Date:2025-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11039841363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily