Provider Demographics
NPI:1386674539
Name:CAMA, CRISTOFORO LOUIS-VINCENT (MD)
Entity Type:Individual
Prefix:DR
First Name:CRISTOFORO
Middle Name:LOUIS-VINCENT
Last Name:CAMA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:4881 NW 8TH AVE
Mailing Address - Street 2:SUITE 2
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32605-4582
Mailing Address - Country:US
Mailing Address - Phone:352-373-6338
Mailing Address - Fax:352-373-6144
Practice Address - Street 1:1179 NW 64TH TER
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32605-4218
Practice Address - Country:US
Practice Address - Phone:352-333-5400
Practice Address - Fax:352-333-5404
Is Sole Proprietor?:No
Enumeration Date:2006-07-04
Last Update Date:2009-12-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME0074128208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL254649300Medicaid
FLG69824Medicare UPIN
FL43583YMedicare ID - Type Unspecified