Healthcare Provider Details

I. General information

NPI: 1992875579
Provider Name (Legal Business Name): CARLOS HUMBERTO OCAMPO M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: CARLOS HUMBERTO OCAMPO M.D.

II. Dates (important events)

Enumeration Date: 11/09/2006
Last Update Date: 02/22/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

424 N DILLARD ST
WINTER GARDEN FL
34787-2817
US

IV. Provider business mailing address

11073 LEDGEMENT LN
WINDERMERE FL
34786-6420
US

V. Phone/Fax

Practice location:
  • Phone: 407-656-7711
  • Fax: 407-656-8328
Mailing address:
  • Phone: 321-438-9282
  • Fax: 407-656-8328

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberME 83808
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: