MEDICARE: OVEED GIOVANNI NIETO CAMACHO APRN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163W00000X	Registered Nurse	RN9465327	FL
2	363LG0600X	Gerontology Nurse Practitioner	APRN11001664	FL

General Provider Information

NPI Number	:	1184131583
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	OVEED GIOVANNI NIETO CAMACHO APRN

Provider Business Mailing Address
First Line	:	6101 BLUE LAGOON DR STE 400
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33126-2051
Country	:	US
Telephone Number	:	305-500-2000
Fax Number	:

Provider Business Practice Location Address
First Line	:	7077 BONNEVAL RD STE 610
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32216-6064
Country	:	US
Telephone Number	:	305-500-2000
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/08/2018
Last Update Date	:	02/13/2026

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