Provider Demographics
NPI:1710415575
Name:CAMACHO GARCIA, ALEJANDRO
Entity Type:Individual
Prefix:
First Name:ALEJANDRO
Middle Name:
Last Name:CAMACHO GARCIA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:420 E 8TH ST APT 107
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33010-4526
Mailing Address - Country:US
Mailing Address - Phone:786-608-2537
Mailing Address - Fax:305-742-2190
Practice Address - Street 1:420 E 8TH ST APT 107
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33010-4526
Practice Address - Country:US
Practice Address - Phone:786-608-2537
Practice Address - Fax:305-742-2190
Is Sole Proprietor?:Yes
Enumeration Date:2017-05-24
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician