Dr Rene Gonzales Camacho PA

Primary specialty

OptometristTaxonomy code 152W00000X

License

OPC5057 Issued in FL

Legal business name

DR RENE GONZALES CAMACHO PA

Practice address

2030 S Ocean Dr
Suite 2221
Hallandale Beach, FL 33009-6649

Phone

(305) 717-8181

NPI assigned

Jul 8, 2015

Organization subpart

No

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

Authorized official

Name

Rene Gonzales Camacho, OD

Title

Owner

Phone

(305) 717-8181

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1436313600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1436400000000",
    "number": "1104209105",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2030 S OCEAN DR",
            "address_2": "SUITE 2221",
            "city": "HALLANDALE BEACH",
            "state": "FL",
            "postal_code": "330096649",
            "telephone_number": "305-717-8181"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2030 S OCEAN DR",
            "address_2": "SUITE 2221",
            "city": "HALLANDALE BEACH",
            "state": "FL",
            "postal_code": "330096649",
            "telephone_number": "305-717-8181"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR RENE GONZALES CAMACHO PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-07-08",
        "last_updated": "2015-07-09",
        "status": "A",
        "authorized_official_last_name": "GONZALES CAMACHO",
        "authorized_official_first_name": "RENE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "305-717-8181",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC5057",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2015; 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.