Provider Demographics
NPI:1235859182
Name:CAMACHO, JUAN OSCAR (MD)
Entity Type:Individual
Prefix:DR
First Name:JUAN
Middle Name:OSCAR
Last Name:CAMACHO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:SENDEROS DEL RIO 860, CARR 175
Mailing Address - Street 2:APT 1125
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00926
Mailing Address - Country:US
Mailing Address - Phone:787-506-5446
Mailing Address - Fax:
Practice Address - Street 1:SENDEROS DEL RIO 860, CARR 175
Practice Address - Street 2:APT 1125
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00926
Practice Address - Country:US
Practice Address - Phone:787-506-5446
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-31
Last Update Date:2022-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR001058-P.A363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant