German Camacho, MD | |
4090 S Ridgewood Ave, Port Orange, FL 32127-4501 | |
(386) 761-0050 | |
(386) 761-1167 |
Full Name | German Camacho |
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Gender | Male |
Speciality | General Practice |
Location | 4090 S Ridgewood Ave, Port Orange, Florida |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
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1912106071 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
208D00000X | General Practice | 16108 (Puerto Rico) | Secondary |
208D00000X | General Practice | ACN270 (Florida) | Primary |
Entity Name | Florida Department Of Children And Families |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1710945118 PECOS PAC ID: 5092613570 Enrollment ID: O20031222000351 |
Entity Name | Conviva Medical Center Management, Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1649324278 PECOS PAC ID: 4284717422 Enrollment ID: O20080212000415 |
Mailing Address | Practice Location Address |
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German Camacho, MD 6101 Blue Lagoon Dr Ste 200, Miami, FL 33126-3168 Ph: (305) 500-2000 | German Camacho, MD 4090 S Ridgewood Ave, Port Orange, FL 32127-4501 Ph: (386) 761-0050 |
Dr. Ricardo Antonio Hernandez Jr., MD General Practice Medicare: Accepting Medicare Assignments Practice Location: 3890 Turtle Creek Dr, Port Orange, FL 32127 Phone: 863-837-9781 Fax: 386-756-3031 | |
Dr. Elizabeth Margaret Mutch, M.D. General Practice Medicare: Not Enrolled in Medicare Practice Location: 986 Wendam Ct, Port Orange, FL 32127 Phone: 386-767-0669 Fax: 386-767-0669 |