Provider Demographics
NPI:1316230006
Name:CAMEJO, RAFAEL ANGEL (ARNP-BC)
Entity Type:Individual
Prefix:
First Name:RAFAEL
Middle Name:ANGEL
Last Name:CAMEJO
Suffix:
Gender:M
Credentials:ARNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17647 SW 150TH CT
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33187-6309
Mailing Address - Country:US
Mailing Address - Phone:786-808-8555
Mailing Address - Fax:786-360-1100
Practice Address - Street 1:8501 SW 124TH AVE STE 110
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33183-4631
Practice Address - Country:US
Practice Address - Phone:786-808-8555
Practice Address - Fax:786-360-1100
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-27
Last Update Date:2023-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9249794363LA2100X
FLAPRN9249794363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care