Provider Demographics
NPI:1689116923
Name:NORBERT CAMACHO DMD PA
Entity Type:Organization
Organization Name:NORBERT CAMACHO DMD PA
Other - Org Name:DENTAL WORLD OF MIAMI
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:NORBERTO
Authorized Official - Middle Name:
Authorized Official - Last Name:CAMACHO
Authorized Official - Suffix:JR
Authorized Official - Credentials:DMD
Authorized Official - Phone:786-266-1094
Mailing Address - Street 1:1646 SW 16TH ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33145-1516
Mailing Address - Country:US
Mailing Address - Phone:305-505-4100
Mailing Address - Fax:305-716-9177
Practice Address - Street 1:75 SE 6TH ST
Practice Address - Street 2:M204
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33131-2886
Practice Address - Country:US
Practice Address - Phone:305-505-4100
Practice Address - Fax:305-716-9177
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-11-16
Last Update Date:2016-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN1905122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty