MEDICARE: FREDERICK A. CAMPOS MD

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	207LP2900X	Pain Medicine (Anesthesiology) Physician	ME 92735	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1285607960
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	FREDERICK A. CAMPOS MD

Provider Business Mailing Address
First Line	:	148 N PALMETTO AVE
Second Line	:
City	:	FLAGLER BEACH
State	:	FL
Zip	:	32136-3303
Country	:	US
Telephone Number	:	386-693-4750
Fax Number	:

Provider Business Practice Location Address
First Line	:	148 N PALMETTO AVE
Second Line	:
City	:	FLAGLER BEACH
State	:	FL
Zip	:	32136-3303
Country	:	US
Telephone Number	:	386-693-4750
Fax Number	:

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

Provider Enumeration Date	:	02/11/2006
Last Update Date	:	10/08/2014

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Directions to “ FREDERICK A. CAMPOS MD” Practice Location

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