Basic Information
| Provider Information | |||||||||
| NPI: | 1023081643 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | MCDONALD-TOUSSAINT | ||||||||
| FirstName: | CAMILLE | ||||||||
| MiddleName: | A. | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | MCDONALD | ||||||||
| OtherFirstName: | CAMILLE | ||||||||
| OtherMiddleName: | A | ||||||||
| OtherNamePrefix: | DR. | ||||||||
| OtherNameSuffix: | |||||||||
| OtherCredential: | MD | ||||||||
| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 1395 NW 167TH ST | ||||||||
| Address2: | |||||||||
| City: | MIAMI GARDENS | ||||||||
| State: | FL | ||||||||
| PostalCode: | 331695710 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9543798994 | ||||||||
| FaxNumber: | 9549772711 | ||||||||
| Practice Location | |||||||||
| Address1: | 6037 KIMBERLY BLVD | ||||||||
| Address2: | |||||||||
| City: | NORTH LAUDERDALE | ||||||||
| State: | FL | ||||||||
| PostalCode: | 330682811 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9543798994 | ||||||||
| FaxNumber: | 9549772711 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/13/2006 | ||||||||
| LastUpdateDate: | 01/22/2020 | ||||||||
| NPIDeactivationReasonCode: | |||||||||
| NPIDeactivationDate: | |||||||||
| NPIReactivationDate: | |||||||||
| ProviderGenderCode: | F | ||||||||
| AuthorizedOfficialLastName: | |||||||||
| AuthorizedOfficialFirstName: | |||||||||
| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | |||||||||
| AuthorizedOfficialTelephone: | |||||||||
| IsSoleProprietor: | N | ||||||||
| IsOrganizationSubpart: | |||||||||
| ParentOrganizationLBN: | |||||||||
| AuthorizedOfficialNamePrefix: | |||||||||
| AuthorizedOfficialNameSuffix: | |||||||||
| AuthorizedOfficialCredential: | |||||||||
| NPICertificationDate: | 01/22/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | ME111799 | FL | Y | Allopathic & Osteopathic Physicians | Family Medicine |
ID Information
| ID | Type | State | Issuer | Description | 009363900 | 05 | FL | MEDICAID | 2218529 | 01 | FL | UNITED | OTHER | ME111799 | 01 | FL | MEDICAL LICENSE | OTHER | 3725959 | 01 | FL | CIGNA | OTHER | 7411416 | 01 | FL | AETNA | OTHER | P01206850 | 01 | FL | RAILROAD MEDICARE | OTHER | 14Q87 | 01 | FL | BCBS | OTHER |