Healthcare Provider Details

I. General information

NPI: 1982303178
Provider Name (Legal Business Name): MILITZA CAMACHO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MILITZA ISABEL CAMACHO MLS (AMT)

II. Dates (important events)

Enumeration Date: 02/27/2023
Last Update Date: 03/09/2023
Certification Date: 03/09/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

27865 SW 133RD PATH
HOMESTEAD FL
33032-8252
US

IV. Provider business mailing address

27865 SW 133RD PATH
HOMESTEAD FL
33032-8252
US

V. Phone/Fax

Practice location:
  • Phone: 305-399-9565
  • Fax:
Mailing address:
  • Phone: 305-399-9565
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code246QM0706X
TaxonomyMedical Technologist
License NumberSU42350
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: