Healthcare Provider Details

I. General information

NPI: 1811744089
Provider Name (Legal Business Name): ARMANDO PUENTES CAMPS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/04/2024
Last Update Date: 05/04/2024
Certification Date: 05/04/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1739 SE 8TH PL
HOMESTEAD FL
33034-5515
US

IV. Provider business mailing address

1739 SE 8TH PL
HOMESTEAD FL
33034-5515
US

V. Phone/Fax

Practice location:
  • Phone: 786-907-2071
  • Fax:
Mailing address:
  • Phone: 786-907-2071
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number11032511
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: