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General NPI Number Information
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NPI Number | 1154415180
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Entity Type | Individual
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Provider Name | ILEANA CAMACHO LND
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Gender | Female
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Dates
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Enumeration Date | 10/03/2006
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | SARDINERA BEACH BUILDING ROAD 693 SUITE 11 URB. COSTA DE ORO
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City | DORADO
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State | PR
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Zip | 00646
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Country | US
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Telephone | 787-796-0959
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Fax | 787-796-0959
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Provider Business Mailing Address
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Address Line | 425 ROAD 693 PMB 179
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City | DORADO
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State | PR
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Zip | 00646
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Country | US
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Telephone | 787-796-0959
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Fax | 787-796-0959
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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 | 133N00000X
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Taxonomy Name | Nutritionist
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License Number | 806
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License Number State | PR
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Taxonomy #2
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Taxonomy Code | 133NN1002X
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Taxonomy Name | Nutrition Education Nutritionist
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License Number | 806
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License Number State | PR
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