Provider Demographics
NPI:1659636637
Name:CAMACHO, NORBERTO (DMD)
Entity Type:Individual
Prefix:DR
First Name:NORBERTO
Middle Name:
Last Name:CAMACHO
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:DR
Other - First Name:NORBERT
Other - Middle Name:
Other - Last Name:CAMACHO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DMD
Mailing Address - Street 1:40 SW 13TH ST STE 801
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33130-4345
Mailing Address - Country:US
Mailing Address - Phone:305-505-4100
Mailing Address - Fax:305-716-9177
Practice Address - Street 1:40 SW 13TH ST STE 801
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33130
Practice Address - Country:US
Practice Address - Phone:305-505-4100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-07-06
Last Update Date:2018-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN19705122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist