Provider Demographics
NPI:1861982639
Name:CAMRON, RHONDA FIDLER
Entity type:Individual
Prefix:
First Name:RHONDA
Middle Name:FIDLER
Last Name:CAMRON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1617 SW 15TH ST
Mailing Address - Street 2:
Mailing Address - City:CAPE CORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33991-2330
Mailing Address - Country:US
Mailing Address - Phone:239-470-5634
Mailing Address - Fax:
Practice Address - Street 1:2489 DIPLOMAT PKWY E
Practice Address - Street 2:
Practice Address - City:CAPE CORAL
Practice Address - State:FL
Practice Address - Zip Code:33909-5422
Practice Address - Country:US
Practice Address - Phone:239-652-1800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-05-16
Last Update Date:2018-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN9335370163W00000X, 163WC0400X, 163WG0000X, 163WG0100X, 163WI0600X, 163WP2201X, 163WM0705X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WM0705XNursing Service ProvidersRegistered NurseMedical-Surgical
No163W00000XNursing Service ProvidersRegistered Nurse
No163WC0400XNursing Service ProvidersRegistered NurseCase Management
No163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice
No163WG0100XNursing Service ProvidersRegistered NurseGastroenterology
No163WI0600XNursing Service ProvidersRegistered NurseInfection Control
No163WP2201XNursing Service ProvidersRegistered NurseAmbulatory Care