Basic Information
Provider Information
NPI: 1619323847
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: MONTES-RAMOS
FirstName: CAMILLE
MiddleName: NATALIA
NamePrefix:  
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 360 N IRBY ST
Address2:  
City: FLORENCE
State: SC
PostalCode: 295012808
CountryCode: US
TelephoneNumber: 8436679414
FaxNumber: 8436671362
Practice Location
Address1: 1920 2ND LOOP RD
Address2:  
City: FLORENCE
State: SC
PostalCode: 295016123
CountryCode: US
TelephoneNumber: 8434323700
FaxNumber: 8434079723
Other Information
ProviderEnumerationDate: 05/06/2016
LastUpdateDate: 08/19/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 08/19/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
208000000X82554SCY Allopathic & Osteopathic PhysiciansPediatrics 

No ID Information.


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