Provider Demographics
NPI:1578984621
Name:CAMACHO, FELIPE (PHARMD, RPH)
Entity Type:Individual
Prefix:DR
First Name:FELIPE
Middle Name:
Last Name:CAMACHO
Suffix:
Gender:M
Credentials:PHARMD, RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12550 PROFESSIONAL PARK DR
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33913-7979
Mailing Address - Country:US
Mailing Address - Phone:239-482-0050
Mailing Address - Fax:
Practice Address - Street 1:12550 PROFESSIONAL PARK DR
Practice Address - Street 2:
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33913-7979
Practice Address - Country:US
Practice Address - Phone:239-482-0050
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-12-16
Last Update Date:2013-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS51435183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist