Individual
JUANA CAMACHO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5535 S WILLIAMSON BLVD, PORT ORANGE, FL 32128-8311
(888) 265-2680
Mailing address
5535 S WILLIAMSON BLVD, PORT ORANGE, FL 32128-8311
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
0119007546
VA
225X00000X
Occupational Therapist
17261
CA
225X00000X
Occupational Therapist
46TR00685200
NJ
Other
Enumeration date
11/16/2017
Last updated
04/15/2019
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