Provider Demographics
NPI:1376656397
Name:DELCAMPILLO, MARIA A (DC)
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:A
Last Name:DELCAMPILLO
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3625 NW 82ND AVE STE 320
Mailing Address - Street 2:
Mailing Address - City:DORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33166-7601
Mailing Address - Country:US
Mailing Address - Phone:305-593-1555
Mailing Address - Fax:305-456-6111
Practice Address - Street 1:3625 NW 82ND AVE STE 320
Practice Address - Street 2:
Practice Address - City:DORAL
Practice Address - State:FL
Practice Address - Zip Code:33166-7601
Practice Address - Country:US
Practice Address - Phone:305-593-1555
Practice Address - Fax:305-456-6111
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-16
Last Update Date:2019-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH 6267111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL280015200Medicaid
FL22623Medicare PIN
FLU13038Medicare UPIN