Provider Demographics
NPI:1881095016
Name:LUIS M CAMPILLO MD, INC
Entity type:Organization
Organization Name:LUIS M CAMPILLO MD, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:LUIS
Authorized Official - Middle Name:M
Authorized Official - Last Name:CAMPILLO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:786-431-5056
Mailing Address - Street 1:7500 SW 8TH ST STE 303A
Mailing Address - Street 2:SUITE 303 A
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33144-4400
Mailing Address - Country:US
Mailing Address - Phone:786-431-5056
Mailing Address - Fax:786-431-5786
Practice Address - Street 1:7500 SW 8TH ST
Practice Address - Street 2:SUITE 303 A
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33144-4400
Practice Address - Country:US
Practice Address - Phone:786-431-5056
Practice Address - Fax:786-431-5786
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-09-08
Last Update Date:2014-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME64856261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center