MEDICARE: CRISTINA E CAMACHO ARNP

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	363LF0000X	Family Nurse Practitioner	ARNP9325061	FL
2	363L00000X	Nurse Practitioner	ARNP9325061	FL

General Provider Information

NPI Number	:	1942749288
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CRISTINA E CAMACHO ARNP

Provider Business Mailing Address
First Line	:	PO BOX 440055
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32222-0001
Country	:	US
Telephone Number	:	904-282-6331
Fax Number	:	904-282-4117

Provider Business Practice Location Address
First Line	:	1909 BEACH BLVD
Second Line	:	SUITE 102
City	:	JACKSONVILLE
State	:	FL
Zip	:	32250-8608
Country	:	US
Telephone Number	:	904-246-2752
Fax Number	:	904-246-2758

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

Provider Enumeration Date	:	02/20/2017
Last Update Date	:	08/31/2017

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Directions to “ CRISTINA E CAMACHO ARNP” Practice Location

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