Individual
JUAN CAMILO CAMACHO VELANDIA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
REGISTER DIETITIAN
Contact information
Practice address
490 N WASHINGTON AVE, TITUSVILLE, FL 32796-2871
(321) 268-4200
(321) 268-1386
Mailing address
3300 S FISKE BLVD, ROCKLEDGE, FL 32955-4306
(321) 268-4200
(321) 268-1386
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
ND10955
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
RI498
PTAN HF
FL
Enumeration date
08/03/2023
Last updated
08/24/2023
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