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General NPI Number Information
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NPI Number | 1093462418
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Entity Type | Individual
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Provider Name | ILIANA CAMEJO
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Gender | Female
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Dates
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Enumeration Date | 03/05/2022
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Last Update Date | 04/03/2025
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Provider Practice Location Address
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Address Line | 4995 NW 72ND AVE STE 201
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City | MIAMI
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State | FL
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Zip | 33166-5643
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Country | US
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Telephone | 786-452-8963
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Fax | 305-675-2727
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Provider Business Mailing Address
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Address Line | 7860 W 4TH LN
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City | HIALEAH
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State | FL
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Zip | 33014-4229
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Country | US
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Telephone | 305-978-2972
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP2300X
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Taxonomy Name | Primary Care Nurse Practitioner
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License Number | F10211021
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License Number State | FL
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