Healthcare Provider Details

I. General information

NPI: 1336569649
Provider Name (Legal Business Name): NATALY CAJAMARCA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/25/2014
Last Update Date: 05/12/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

911 E ATLANTIC BLVD STE 108A
POMPANO BEACH FL
33060-7372
US

IV. Provider business mailing address

1943 POLK ST
HOLLYWOOD FL
33020-4510
US

V. Phone/Fax

Practice location:
  • Phone: 954-941-2323
  • Fax:
Mailing address:
  • Phone: 786-389-8319
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: