Healthcare Provider Details

I. General information

NPI: 1932387271
Provider Name (Legal Business Name): ANGELA M CAMACHO-DURAN M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/08/2008
Last Update Date: 05/16/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8206 NW 52ND ST
GAINESVILLE FL
32653-6152
US

IV. Provider business mailing address

DEPT OF PSYCHIATRY BOX 100256
GAINESVILLE FL
32610-0256
US

V. Phone/Fax

Practice location:
  • Phone: 352-392-3681
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberME127581
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: