Healthcare Provider Details

I. General information

NPI: 1487816963
Provider Name (Legal Business Name): ANDRE RAPOSOS DA CAMARA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/26/2008
Last Update Date: 04/17/2023
Certification Date: 04/17/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1600 SW ARCHER RD
GAINESVILLE FL
32610-3003
US

IV. Provider business mailing address

PO BOX 100254
GAINESVILLE FL
32610-0254
US

V. Phone/Fax

Practice location:
  • Phone: 352-392-3441
  • Fax: 352-392-7029
Mailing address:
  • Phone: 352-392-3441
  • Fax: 352-392-7029

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberME115699
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: