Basic Information
| Provider Information | |||||||||
| NPI: | 1619445145 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | CAMACHO-CASTRO | ||||||||
| FirstName: | ANGIE | ||||||||
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| Mailing Information | |||||||||
| Address1: | 17611 SW 8TH CT | ||||||||
| Address2: | |||||||||
| City: | PEMBROKE PINES | ||||||||
| State: | FL | ||||||||
| PostalCode: | 330294842 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 2901 CORAL HILLS DR STE 370 | ||||||||
| Address2: | |||||||||
| City: | CORAL SPRINGS | ||||||||
| State: | FL | ||||||||
| PostalCode: | 330654146 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9546039630 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 11/02/2018 | ||||||||
| LastUpdateDate: | 11/02/2018 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163W00000X | RN9353161 | FL | Y | Nursing Service Providers | Registered Nurse |
No ID Information.