NPIMap

Organization Active NPI

Ivan D Camacho MD PA

  • Dermatology Physician
  • Miami, FL
National Provider Identifier
1093145831
Registry record updated Nov 14, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
ME109790 Issued in FL
Legal business name
IVAN D CAMACHO MD PA
Practice address
79 SW 12 St #3907
Miami, FL 33130-5215
Phone
(786) 475-7555
Fax
(786) 475-7556
NPI assigned
Nov 14, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 14, 2013

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Ivan D Camacho, M.D.NPI 1194999227
Title
President
Phone
(305) 987-9375

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207N00000X ME109790 FL Primary

Addresses

Primary practice location

79 SW 12 St #3907
Miami, FL 33130-5215

Mailing address

79 SW 12 St #3907
Miami, FL 33130-5215
Phone (786) 475-7555

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1384387200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1384387200000",
    "number": "1093145831",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "79 SW 12 ST #3907",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331305215",
            "telephone_number": "786-475-7555",
            "fax_number": "786-475-7556"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "79 SW 12 ST #3907",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331305215",
            "telephone_number": "786-475-7555",
            "fax_number": "786-475-7556"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IVAN D CAMACHO MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-11-14",
        "last_updated": "2013-11-14",
        "status": "A",
        "authorized_official_last_name": "CAMACHO",
        "authorized_official_first_name": "IVAN",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "305-987-9375",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": "FL",
            "license": "ME109790",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.