Individual provider Active NPI

Camilo Homero Leon Marin, DC

  • Chiropractor
  • Belle Glade, FL
National Provider Identifier
1538910401
Registry record updated Mar 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH14990 Issued in FL
Practice address
1100 S Main St Unit 3
Belle Glade, FL 33430-4910
Phone
(561) 996-7073
NPI assigned
Mar 28, 2024
Last updated
Mar 28, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 28, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CH14990 FL Primary

Addresses

Primary practice location

1100 S Main St Unit 3
Belle Glade, FL 33430-4910

Mailing address

1100 S Main St Unit 3
Belle Glade, FL 33430-4910

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240515004585 FL Practitioner - Chiropractic 1456792803 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Royal Palm Beach Rehab, CorpGroup PAC ID 3476683335, 62 clinicians

Practice addresses (Care Compare)

1100 S Main St
Suite 103
Belle Glade, FL 33430-4910
Phone (561) 996-7032

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CH14990FLMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Royal Palm Beach Rehab, Corp Chiropractor CurrentSince Apr 2, 2024 Accepting new patients
Royal Palm Beach Rehab, Corp Chiropractor CurrentSince Apr 2, 2024 Accepting new patients
Royal Palm Beach Rehab, Corp Chiropractor Past Accepting new patients

Locations

1100 S Main St
Ste 103
Belle Glade, FL 33430
Phone (561) 996-7032

9325 Glades Rd
Ste 104
Boca Raton, FL 33434
Phone (561) 513-8380

4971 Le Chalet Blvd
Ste 100
Boynton Beach, FL 33436
Phone (561) 733-5590

6415 Lake Worth Rd
Ste 309
Greenacres, FL 33463
Phone (561) 318-7432

106 Ponce de Leon St
Royal Palm Beach, FL 33411
Phone (561) 236-3741

Networks

  • Freedom Health HMO Network

Organizations & group practices 3

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": "1711584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711584000000",
    "number": "1538910401",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 S MAIN ST UNIT 3",
            "city": "BELLE GLADE",
            "state": "FL",
            "postal_code": "334304910"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 S MAIN ST UNIT 3",
            "city": "BELLE GLADE",
            "state": "FL",
            "postal_code": "334304910",
            "telephone_number": "561-996-7073"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEON MARIN",
        "first_name": "CAMILO",
        "middle_name": "HOMERO",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-03-28",
        "last_updated": "2024-03-28",
        "certification_date": "2024-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH14990",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Belle Glade, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.