Provider Demographics
NPI:1205044708
Name:CAMACHO, ALEXANDER (DC)
Entity Type:Individual
Prefix:DR
First Name:ALEXANDER
Middle Name:
Last Name:CAMACHO
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 878
Mailing Address - Street 2:
Mailing Address - City:PLYMOUTH
Mailing Address - State:FL
Mailing Address - Zip Code:32768-0878
Mailing Address - Country:US
Mailing Address - Phone:407-758-8672
Mailing Address - Fax:
Practice Address - Street 1:1040 ABERNATHY LN
Practice Address - Street 2:#206
Practice Address - City:APOPKA
Practice Address - State:FL
Practice Address - Zip Code:32703-2905
Practice Address - Country:US
Practice Address - Phone:407-758-8672
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH7825111NS0005X
TX5740111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NS0005XChiropractic ProvidersChiropractorSports Physician