Provider Demographics
NPI:1851966337
Name:CAMACHO, BARBARA LEE
Entity Type:Individual
Prefix:
First Name:BARBARA
Middle Name:LEE
Last Name:CAMACHO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:BO. HATO ARRIBA, CARR 129 KM 3.3, ARECIBO P.R. 00612
Mailing Address - Street 2:P.O. BOX 1323, UTUADO,P.R. 00641
Mailing Address - City:ARECIBO
Mailing Address - State:PR
Mailing Address - Zip Code:00612
Mailing Address - Country:US
Mailing Address - Phone:787-329-0250
Mailing Address - Fax:
Practice Address - Street 1:BO. HATO ARRIBA, CARR 129 KM 3.3, ARECIBO,P.R. 00612
Practice Address - Street 2:
Practice Address - City:ARECIBO
Practice Address - State:PR
Practice Address - Zip Code:00612
Practice Address - Country:US
Practice Address - Phone:787-329-0250
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-26
Last Update Date:2021-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
363A00000X
PR000905-P.A.363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant