Healthcare Provider Details

I. General information

NPI: 1609397231
Provider Name (Legal Business Name): MAILEN CAMACHO ARNP,FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/05/2017
Last Update Date: 02/02/2023
Certification Date: 02/02/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7831 W 36TH AVE UNIT 202
HIALEAH FL
33018-7525
US

IV. Provider business mailing address

7831 W 36TH AVE UNIT 202
HIALEAH FL
33018-7525
US

V. Phone/Fax

Practice location:
  • Phone: 786-444-8856
  • Fax: 786-444-8856
Mailing address:
  • Phone: 786-444-8856
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAPRN9240193
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number9240193
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: