Provider Demographics
NPI:1326008947
Name:CAMEJO, LEONEL (MD)
Entity Type:Individual
Prefix:
First Name:LEONEL
Middle Name:
Last Name:CAMEJO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4714 N ARMENIA AVE STE 100
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33603-2603
Mailing Address - Country:US
Mailing Address - Phone:813-443-5224
Mailing Address - Fax:813-443-5324
Practice Address - Street 1:7015 N ARMENIA AVE
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33604
Practice Address - Country:US
Practice Address - Phone:813-443-5224
Practice Address - Fax:813-443-5324
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-27
Last Update Date:2018-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME 87573207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL274440600Medicaid
FLH92922Medicare UPIN