Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 111NS0005X | Chiropractic Sports Physician | 5740 | TX |
Y | 111NS0005X | Chiropractic Sports Physician | CH7825 | FL |
NPI | 1205044708 |
---|---|
Provider Name | Dr. Alexander Camacho |
First Address | Plymouth, FL 32768-0878 |
Second Address | Apopka, FL 32703-2905 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/05/2007 |
Last Update Date | 08/07/2007 |