Provider Demographics
NPI:1265870141
Name:CAMERO, MABELITA S
Entity type:Individual
Prefix:MS
First Name:MABELITA
Middle Name:S
Last Name:CAMERO
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 1:600 E NORTHERN LIGHTS BLVD
Mailing Address - Street 2:SUITE L
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99503-4162
Mailing Address - Country:US
Mailing Address - Phone:907-277-8431
Mailing Address - Fax:907-277-8724
Practice Address - Street 1:600 E NORTHERN LIGHTS BLVD
Practice Address - Street 2:SUITE L
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99503-4162
Practice Address - Country:US
Practice Address - Phone:907-277-8431
Practice Address - Fax:907-277-8724
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-12
Last Update Date:2013-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK33156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician