Individual provider Active NPI

Elizeu Sabino Camargo

  • Marriage & Family Therapist
  • Saint Cloud, FL
National Provider Identifier
1215414701
Registry record updated Jul 26, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
Practice address
1203 Florida Ave
Saint Cloud, FL 34769-3721
Phone
(407) 593-2757
NPI assigned
Jul 26, 2018
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 26, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X Primary

Addresses

Primary practice location

1203 Florida Ave
Saint Cloud, FL 34769-3721

Mailing address

2017 Bridgeview Cir
Orlando, FL 32824-5620
Phone (407) 879-7728

Other practice location 1

1203 Florida Ave
Saint Cloud, FL 34769-3721
Phone (407) 593-2757

Other identifiers 1

IdentifierTypeStateIssuer
IMH17020MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1532563200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1532563200000",
    "number": "1215414701",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2017 BRIDGEVIEW CIR",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328245620",
            "telephone_number": "407-879-7728"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1203 FLORIDA AVE",
            "city": "SAINT CLOUD",
            "state": "FL",
            "postal_code": "347693721",
            "telephone_number": "407-593-2757"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1203 Florida Ave",
            "address_purpose": "LOCATION",
            "city": "Saint Cloud",
            "state": "FL",
            "postal_code": "347693721",
            "country_code": "US",
            "telephone_number": "407-593-2757",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CAMARGO",
        "first_name": "ELIZEU",
        "middle_name": "SABINO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-07-26",
        "last_updated": "2018-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "IMH17020",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Cloud, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2018; 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.