1730253329 NPI number — EDUARDO B. CAMPS-ROMERO MD

Table of content: EDUARDO B. CAMPS-ROMERO MD (NPI 1730253329)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1730253329 NPI number — EDUARDO B. CAMPS-ROMERO MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
CAMPS-ROMERO
Provider First Name:
EDUARDO
Provider Middle Name:
B.
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
CAMPS
Provider Other First Name:
EDUARDO
Provider Other Middle Name:
BENJAMIN
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
M.D.
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1730253329
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/06/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
11200 SW 8TH ST
Provider Second Line Business Mailing Address:
AHC2 #694
Provider Business Mailing Address City Name:
MIAMI
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33199-2516
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
305-348-0669
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
800 SW 108TH AVE
Provider Second Line Business Practice Location Address:
ACC 100
Provider Business Practice Location Address City Name:
MIAMI
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33174-2555
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
305-348-3267
Provider Business Practice Location Address Fax Number:
305-348-4261
Provider Enumeration Date:
11/17/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 2084P0800X , with the licence number:  ME116320 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 017214800 . This is a "Florida Medicaid Provider ID" identifier , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".




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