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General NPI Number Information
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NPI Number | 1871949701
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Entity Type | Organization
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Legal Business Name | LARISSA CAMEJO, MD.PA.
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Dates
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Enumeration Date | 05/10/2016
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Last Update Date | 06/08/2023
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Provider Practice Location Address
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Address Line | 11211 PROSPERITY FARMS RD STE D127
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City | PALM BEACH GARDENS
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State | FL
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Zip | 33410-3449
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Country | US
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Telephone | 561-223-6557
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Fax | 561-526-8754
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Provider Business Mailing Address
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Address Line | 2105 SPRING CT
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City | PALM BEACH GARDENS
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State | FL
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Zip | 33410-1297
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Country | US
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Telephone | 215-888-8345
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Fax |
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Authorized Official
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Title or Position | OPHTHALMOLOGIST, GLAUCOMA SPECIALIS
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Name | DR. LARISSA CAMEJO
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Credential | MD
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Telephone | 215-888-8345
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | ME106908
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License Number State | FL
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