Provider Demographics
NPI:1235003450
Name:CAMACHO HOME HEALTH LLC
Entity type:Organization
Organization Name:CAMACHO HOME HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LARITZA
Authorized Official - Middle Name:
Authorized Official - Last Name:CAMACHO LAURENCIO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:904-490-8876
Mailing Address - Street 1:6110 POWERS AVE STE B
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32217-1206
Mailing Address - Country:US
Mailing Address - Phone:904-490-8876
Mailing Address - Fax:904-539-5600
Practice Address - Street 1:6110 POWERS AVE STE B
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32217-1206
Practice Address - Country:US
Practice Address - Phone:904-490-8876
Practice Address - Fax:904-539-5600
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-10-01
Last Update Date:2025-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health