MEDICARE: TERESA CAMARA

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	163WC0400X	Case Management Registered Nurse	RN9368942	FL
2	163WC0400X	Case Management Registered Nurse	T165935	TX

General Provider Information

NPI Number	:	1508270331
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TERESA CAMARA

Provider Business Mailing Address
First Line	:	4730 N HABANA AVE STE 204
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33614-7148
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4730 N HABANA AVE STE 204
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33614-7148
Country	:	US
Telephone Number	:	813-549-2134
Fax Number	:	813-870-1383

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

Provider Enumeration Date	:	06/19/2014
Last Update Date	:	06/19/2014

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Directions to “ TERESA CAMARA ” Practice Location

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