Healthcare Provider Details

I. General information

NPI: 1154320729
Provider Name (Legal Business Name): CAMELOT HEALTHCARE MANAGEMENT, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/18/2005
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12240 SW 128TH CT STE 108
MIAMI FL
33186-4782
US

IV. Provider business mailing address

12240 SW 128TH COURT SUITE 108
MIAMI FL
33186
US

V. Phone/Fax

Practice location:
  • Phone: 305-267-2278
  • Fax: 305-267-2279
Mailing address:
  • Phone: 305-267-2278
  • Fax: 305-267-2279

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License NumberHME907
License Number StateFL

VIII. Authorized Official

Name: MR. ANGEL ARCIERO
Title or Position: PRESIDENT
Credential:
Phone: 305-267-2278