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General NPI Number Information
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NPI Number | 1154879278
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Entity Type | Individual
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Provider Name | DIALIS ENEIDA CAMACHO LM, CPM
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Gender | Female
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Dates
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Enumeration Date | 09/18/2016
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Last Update Date | 09/18/2016
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Provider Practice Location Address
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Address Line | 8203 NW 31ST AVE APT. G41
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City | GAINESVILLE
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State | FL
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Zip | 32606-6289
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Country | US
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Telephone | 787-228-3444
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Fax |
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Provider Business Mailing Address
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Address Line | 8203 NW 31ST AVE APT. G41
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City | GAINESVILLE
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State | FL
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Zip | 32606-6289
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Country | US
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Telephone | 787-228-3444
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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 | 176B00000X
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Taxonomy Name | Midwife
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License Number | 338
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License Number State | FL
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