Camilo O Moynelo Coll, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DN23641 Issued in FL

Practice address

1620 S Congress Ave Ste 102
Palm Springs, FL 33461-2128

Phone

(561) 508-5930

NPI assigned

Jul 5, 2018

Last updated

Aug 15, 2021By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Networks

• Freedom Health HMO Network

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

{
    "created_epoch": "1530748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628985600000",
    "number": "1376039115",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13707 BARBERRY DR",
            "city": "WELLINGTON",
            "state": "FL",
            "postal_code": "334148143",
            "telephone_number": "305-302-7367"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1620 S CONGRESS AVE STE 102",
            "city": "PALM SPRINGS",
            "state": "FL",
            "postal_code": "334612128",
            "telephone_number": "561-508-5930"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6301 S Dixie Hwy",
            "address_purpose": "LOCATION",
            "city": "West Palm Beach",
            "state": "FL",
            "postal_code": "334054328",
            "country_code": "US",
            "telephone_number": "561-588-4066",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOYNELO COLL",
        "first_name": "CAMILO",
        "middle_name": "O",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-07-05",
        "last_updated": "2021-08-15",
        "certification_date": "2021-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN23641",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• General Practice Dentistry in Palm Springs, FL
• Providers in Palm Springs, FL by specialty
• General Practice Dentistry in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2021; 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.