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General NPI Number Information
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NPI Number | 1730580366
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Entity Type | Organization
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Legal Business Name | INCEPTION HEALTHCARE SOLUTIONS LLC
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Dates
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Enumeration Date | 09/15/2014
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Last Update Date | 09/15/2014
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Provider Practice Location Address
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Address Line | 14701 BARTRAM PARK BLVD UNIT 1118
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City | JACKSONVILLE
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State | FL
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Zip | 32258-5296
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Country | US
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Telephone | 561-232-4519
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Fax |
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Provider Business Mailing Address
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Address Line | 14701 BARTRAM PARK BLVD UNIT 1118
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City | JACKSONVILLE
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State | FL
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Zip | 32258-5296
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Country | US
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Telephone | 561-232-4519
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Fax |
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Authorized Official
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Title or Position | PRESIDENT AND CEO
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Name | DR. JULIO LUIS CAMACHO
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Credential | PHARM.D.
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Telephone | 561-232-4519
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number | PS43223
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License Number State | FL
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