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NPI Code Detail

MEDICARE: MR. LUIS CAMACHO P.A.

MEDICARE:  MR. LUIS  CAMACHO  P.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
1207N00000XDermatology PhysicianPA9103060FL
2363AS0400XSurgical Physician AssistantPA9103060FL

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 : 1659423358
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. LUIS CAMACHO P.A.
Provider Business Mailing Address
First Line : 8625 COLLIER BLVD
Second Line :
City : NAPLES
State : FL
Zip : 34114-3550
Country : US
Telephone Number : 239-732-0044
Fax Number : 239-732-0094
Provider Business Practice Location Address
First Line : 8625 COLLIER BLVD
Second Line :
City : NAPLES
State : FL
Zip : 34114-3550
Country : US
Telephone Number : 239-732-0044
Fax Number : 239-732-0094
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/16/2007
Last Update Date : 03/16/2021

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Directions to “ MR. LUIS CAMACHO P.A.” Practice Location

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