Provider Demographics
NPI:1154320729
Name:CAMELOT HEALTHCARE MANAGEMENT, INC.
Entity Type:Organization
Organization Name:CAMELOT HEALTHCARE MANAGEMENT, INC.
Other - Org Name:SUNCARE RESPIRATORY SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ANGEL
Authorized Official - Middle Name:
Authorized Official - Last Name:ARCIERO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-267-2278
Mailing Address - Street 1:12240 SW 128TH COURT
Mailing Address - Street 2:SUITE 108
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33186
Mailing Address - Country:US
Mailing Address - Phone:305-267-2278
Mailing Address - Fax:305-267-2279
Practice Address - Street 1:12240 SW 128TH CT STE 108
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33186-4782
Practice Address - Country:US
Practice Address - Phone:305-267-2278
Practice Address - Fax:305-267-2279
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-18
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332B00000X
FLHME907332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL025290500Medicaid
FL025290500Medicaid