MEDICARE: CAMILA QUEIROZ HURTADO

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	28264929A	IN
2	367500000X	Certified Registered Nurse Anesthetist	28264929A	IN

General Provider Information

NPI Number	:	1700471927
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CAMILA QUEIROZ HURTADO

Provider Business Mailing Address
First Line	:	1016 SWEETBROOK WAY
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32828-8627
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1016 SWEETBROOK WAY
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32828-8627
Country	:	US
Telephone Number	:	407-692-0813
Fax Number	:

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

Provider Enumeration Date	:	03/09/2021
Last Update Date	:	09/12/2024

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