Provider Demographics
NPI:1992392195
Name:CAMACHO, NAYIBETH (BA)
Entity Type:Individual
Prefix:
First Name:NAYIBETH
Middle Name:
Last Name:CAMACHO
Suffix:
Gender:F
Credentials:BA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:241 RUBY AVE STE 204
Mailing Address - Street 2:
Mailing Address - City:KISSIMMEE
Mailing Address - State:FL
Mailing Address - Zip Code:34741-5627
Mailing Address - Country:US
Mailing Address - Phone:407-978-6352
Mailing Address - Fax:
Practice Address - Street 1:241 RUBY AVE STE 204
Practice Address - Street 2:
Practice Address - City:KISSIMMEE
Practice Address - State:FL
Practice Address - Zip Code:34741-5627
Practice Address - Country:US
Practice Address - Phone:321-805-0883
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-22
Last Update Date:2020-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist