Provider Demographics
NPI:1346763828
Name:CAMACHO, ROSSE MARIE
Entity Type:Individual
Prefix:
First Name:ROSSE
Middle Name:MARIE
Last Name:CAMACHO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9975 TAVISTOCK LAKES BLVD STE 140
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32827-7559
Mailing Address - Country:US
Mailing Address - Phone:407-930-7803
Mailing Address - Fax:407-930-7807
Practice Address - Street 1:9975 TAVISTOCK LAKES BLVD STE 140
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32827-7559
Practice Address - Country:US
Practice Address - Phone:407-930-7803
Practice Address - Fax:407-930-7807
Is Sole Proprietor?:No
Enumeration Date:2017-07-17
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist