Healthcare Provider Details

I. General information

NPI: 1013663376
Provider Name (Legal Business Name): YAKIMA ESCALONA CAMEJO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/25/2022
Last Update Date: 02/25/2022
Certification Date: 02/25/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6621 DEL PRADO TER
NEW PORT RICHEY FL
34652-1503
US

IV. Provider business mailing address

6621 DEL PRADO TER
NEW PORT RICHEY FL
34652-1503
US

V. Phone/Fax

Practice location:
  • Phone: 786-366-8360
  • Fax:
Mailing address:
  • Phone: 786-366-8360
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: