Provider Demographics
NPI:1083790935
Name:CAMACHO, ANGEL (RN)
Entity Type:Individual
Prefix:MR
First Name:ANGEL
Middle Name:
Last Name:CAMACHO
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:LOS FLORES 411
Mailing Address - Street 2:HC 02 BOX 10185
Mailing Address - City:YAUCO
Mailing Address - State:PR
Mailing Address - Zip Code:00698-9603
Mailing Address - Country:US
Mailing Address - Phone:787-824-0284
Mailing Address - Fax:787-824-2022
Practice Address - Street 1:PRARNG SOHO
Practice Address - Street 2:CAMP.SANTIAGO
Practice Address - City:SALINAS
Practice Address - State:PR
Practice Address - Zip Code:00902-3786
Practice Address - Country:US
Practice Address - Phone:787-824-0284
Practice Address - Fax:787-824-2022
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR000883163WX0106X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WX0106XNursing Service ProvidersRegistered NurseOccupational Health