MEDICARE: FABIOLA EUGENIA CAMACHO DDS

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	1223G0001X	General Practice Dentistry	DN23892	FL

General Provider Information

NPI Number	:	1740746551
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	FABIOLA EUGENIA CAMACHO DDS

Provider Business Mailing Address
First Line	:	1142 E STATE ROAD 434
Second Line	:
City	:	WINTER SPRINGS
State	:	FL
Zip	:	32708-2715
Country	:	US
Telephone Number	:	786-554-9020
Fax Number	:	786-554-9020

Provider Business Practice Location Address
First Line	:	1142 E STATE ROAD 434
Second Line	:
City	:	WINTER SPRINGS
State	:	FL
Zip	:	32708-2715
Country	:	US
Telephone Number	:	407-327-2030
Fax Number	:

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

Provider Enumeration Date	:	02/17/2019
Last Update Date	:	12/16/2025

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