Provider Demographics
NPI:1407390990
Name:CAMUS MEDICAL PRACTICE
Entity Type:Organization
Organization Name:CAMUS MEDICAL PRACTICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:DEBBIE
Authorized Official - Middle Name:
Authorized Official - Last Name:CAMOGLIANO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:352-259-3435
Mailing Address - Street 1:1400 N US HIGHWAY 441
Mailing Address - Street 2:BLDG 900 STE 904
Mailing Address - City:THE VILLAGES
Mailing Address - State:FL
Mailing Address - Zip Code:32159-8975
Mailing Address - Country:US
Mailing Address - Phone:352-259-3435
Mailing Address - Fax:352-259-3438
Practice Address - Street 1:1400 N US HIGHWAY 441
Practice Address - Street 2:BLDG 900 STE 904
Practice Address - City:THE VILLAGES
Practice Address - State:FL
Practice Address - Zip Code:32159-8975
Practice Address - Country:US
Practice Address - Phone:352-259-3435
Practice Address - Fax:352-259-3438
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-12-19
Last Update Date:2016-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty