Provider Demographics
NPI:1083958409
Name:CAMEJO, LIBERTAD LIDIA (RN)
Entity Type:Individual
Prefix:MRS
First Name:LIBERTAD
Middle Name:LIDIA
Last Name:CAMEJO
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2719 SW 8TH CT
Mailing Address - Street 2:
Mailing Address - City:CAPE CORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33914-4102
Mailing Address - Country:US
Mailing Address - Phone:239-895-2141
Mailing Address - Fax:
Practice Address - Street 1:2719 SW 8TH CT
Practice Address - Street 2:
Practice Address - City:CAPE CORAL
Practice Address - State:FL
Practice Address - Zip Code:33914-4102
Practice Address - Country:US
Practice Address - Phone:239-895-2141
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-11-26
Last Update Date:2012-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN 9332410163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse