Provider Demographics
NPI:1477321636
Name:ANA CAMPUZANO PRIMARY CARE SERVICES
Entity Type:Organization
Organization Name:ANA CAMPUZANO PRIMARY CARE SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:ANA
Authorized Official - Middle Name:V
Authorized Official - Last Name:CAMPUZANO
Authorized Official - Suffix:
Authorized Official - Credentials:APRN
Authorized Official - Phone:786-808-9400
Mailing Address - Street 1:18901 SW 106TH AVE STE 209
Mailing Address - Street 2:
Mailing Address - City:CUTLER BAY
Mailing Address - State:FL
Mailing Address - Zip Code:33157-7664
Mailing Address - Country:US
Mailing Address - Phone:305-992-1552
Mailing Address - Fax:786-685-2447
Practice Address - Street 1:18901 SW 106TH AVE STE 209
Practice Address - Street 2:
Practice Address - City:CUTLER BAY
Practice Address - State:FL
Practice Address - Zip Code:33157-7664
Practice Address - Country:US
Practice Address - Phone:305-992-1552
Practice Address - Fax:786-685-2447
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-12-18
Last Update Date:2023-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty