Healthcare Provider Details

I. General information

NPI: 1891748679
Provider Name (Legal Business Name): ANA CAMACHO M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/19/2006
Last Update Date: 09/05/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5210 LINTON BLVD SUITE 307
DELRAY BEACH FL
33484-6542
US

IV. Provider business mailing address

5210 LINTON BLVD SUITE 307
DELRAY BEACH FL
33484-6542
US

V. Phone/Fax

Practice location:
  • Phone: 561-499-0660
  • Fax: 561-499-4094
Mailing address:
  • Phone: 561-499-0660
  • Fax: 561-499-4094

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207ND0900X
TaxonomyDermatopathology Physician
License NumberME73366
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: