Healthcare Provider Details

I. General information

NPI: 1316288624
Provider Name (Legal Business Name): LUIS ROBERTO CAMPIS VAZQUEZ M.D
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/12/2013
Last Update Date: 05/27/2026
Certification Date: 05/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3097 CURRY FORD RD STE C
ORLANDO FL
32806-3303
US

IV. Provider business mailing address

3097 CURRY FORD RD STE C
ORLANDO FL
32806-3303
US

V. Phone/Fax

Practice location:
  • Phone: 689-230-9051
  • Fax: 689-204-1487
Mailing address:
  • Phone: 689-224-0904
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberME124806
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: