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General NPI Number Information
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NPI Number | 1588898258
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Entity Type | Individual
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Provider Name | SUNY MARIEL CAMINERO M.D.
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Gender | Female
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Dates
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Enumeration Date | 05/11/2009
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Last Update Date | 06/05/2025
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Provider Practice Location Address
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Address Line | 486 TOWN PLAZA AVE STE 440
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City | PONTE VEDRA
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State | FL
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Zip | 32081-5142
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Country | US
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Telephone | 904-496-4848
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Fax | 904-341-5482
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Provider Business Mailing Address
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Address Line | 486 TOWN PLAZA AVE STE 440
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City | PONTE VEDRA
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State | FL
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Zip | 32081-5142
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Country | US
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Telephone | 904-496-4848
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Fax | 904-341-5482
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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 | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | ME 115063
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License Number State | FL
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