Individual provider Active NPI

Leonila D Camba, M.D.

  • Internal Medicine Physician
  • Plant City, FL
National Provider Identifier
1396765939
Registry record updated Oct 3, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
ME0065228 Issued in FL
Practice address
2004 Thonotosassa Rd
Suite 101
Plant City, FL 33563-2915
Phone
(813) 759-1290
Fax
(813) 759-1291
NPI assigned
Jul 19, 2006
Last updated
Oct 3, 2011By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 3, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X ME0065228 FL Primary
Nephrology Physician 207RN0300X ME00065228 FL

Addresses

Primary practice location

2004 Thonotosassa Rd
Suite 101
Plant City, FL 33563-2915

Mailing address

2004 Thonotosassa Rd
Suite 101
Plant City, FL 33563-2915
Phone (813) 759-1290

Other identifiers 1

IdentifierTypeStateIssuer
257820400MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080726000030 FL Practitioner - NephrologyPractitioner - Internal Medicine 8123191954

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
ME0065228FLMDInternal Medicine Physician
ME00065228FLMDNephrology Physician

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1153267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1317600000000",
    "number": "1396765939",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2004 THONOTOSASSA RD",
            "address_2": "SUITE 101",
            "city": "PLANT CITY",
            "state": "FL",
            "postal_code": "335632915",
            "telephone_number": "813-759-1290",
            "fax_number": "813-759-1291"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2004 THONOTOSASSA RD",
            "address_2": "SUITE 101",
            "city": "PLANT CITY",
            "state": "FL",
            "postal_code": "335632915",
            "telephone_number": "813-759-1290",
            "fax_number": "813-759-1291"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAMBA",
        "first_name": "LEONILA",
        "middle_name": "D",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-19",
        "last_updated": "2011-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME0065228",
            "primary": true
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "FL",
            "license": "ME00065228",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "257820400",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Plant City, FL

Sources for this page

Verify at the official NPI Registry.