Provider Demographics
NPI:1003912502
Name:ALVARO J OCAMPO MD PA
Entity Type:Organization
Organization Name:ALVARO J OCAMPO MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESICENT
Authorized Official - Prefix:
Authorized Official - First Name:ALVARO
Authorized Official - Middle Name:J
Authorized Official - Last Name:OCAMPO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:305-951-9010
Mailing Address - Street 1:5961 SW 81ST ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33143-8119
Mailing Address - Country:US
Mailing Address - Phone:305-951-9010
Mailing Address - Fax:
Practice Address - Street 1:735 NW 22ND AVE
Practice Address - Street 2:SPACE B
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33125-3339
Practice Address - Country:US
Practice Address - Phone:305-324-7111
Practice Address - Fax:305-324-7117
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-15
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLHCC5187207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLE2616AMedicare ID - Type Unspecified