Healthcare Provider Details

I. General information

NPI: 1740746551
Provider Name (Legal Business Name): FABIOLA EUGENIA CAMACHO DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/17/2019
Last Update Date: 12/16/2025
Certification Date: 12/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1142 E STATE ROAD 434
WINTER SPRINGS FL
32708-2715
US

IV. Provider business mailing address

1142 E STATE ROAD 434
WINTER SPRINGS FL
32708-2715
US

V. Phone/Fax

Practice location:
  • Phone: 407-327-2030
  • Fax:
Mailing address:
  • Phone: 786-554-9020
  • Fax: 786-554-9020

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License NumberDN23892
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: