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NPI Code Detail

MEDICARE: MR. KADEEM OMAR CAMPBELL M.A.

MEDICARE: MR. KADEEM OMAR CAMPBELL M.A.
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
1101YM0800XMental Health Counselor

Other Identifiers

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

General Provider Information

NPI Number : 1467944876
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. KADEEM OMAR CAMPBELL M.A.
Provider Business Mailing Address
First Line : 1707 ORLANDO CENTRAL PKWY STE 480
Second Line :
City : ORLANDO
State : FL
Zip : 32809-5785
Country : US
Telephone Number : 407-382-9079
Fax Number :
Provider Business Practice Location Address
First Line : 1707 ORLANDO CENTRAL PKWY STE 480
Second Line :
City : ORLANDO
State : FL
Zip : 32809-5785
Country : US
Telephone Number : 407-382-9079
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/31/2018
Last Update Date : 06/23/2026

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