Provider Demographics
NPI:1245642180
Name:MURILLO, CAMILO ANDRES (APRN, FNP-BC)
Entity type:Individual
Prefix:MR
First Name:CAMILO
Middle Name:ANDRES
Last Name:MURILLO
Suffix:
Gender:M
Credentials:APRN, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3436 SW 23RD TER
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33145-3023
Mailing Address - Country:US
Mailing Address - Phone:305-812-2208
Mailing Address - Fax:
Practice Address - Street 1:3436 SW 23RD TER
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33145-3023
Practice Address - Country:US
Practice Address - Phone:305-871-9608
Practice Address - Fax:305-390-4659
Is Sole Proprietor?:Yes
Enumeration Date:2014-05-27
Last Update Date:2021-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11010959363LP2300X
FLPN5180825164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
No164W00000XNursing Service ProvidersLicensed Practical Nurse