Campillo Medical Corp

Primary specialty

Community Health Clinic/CenterTaxonomy code 261QC1500X

Legal business name

CAMPILLO MEDICAL CORP

Doing business as

Campillo Medical Corp

Practice address

6583 SW 39TH Ter
Miami, FL 33155-4821

Phone

(786) 615-3187

Fax

(786) 756-1010

NPI assigned

May 29, 2017

Organization subpart

No

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

Authorized official

Name

Eric Campillo-Juig, APRN, LHHCNPI 1205039005

Title

Clinical Director

Phone

(305) 300-5551

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• CAMPILLO MEDICAL CORP Doing business as

Medicare fee-for-service enrollment

Enrolled in FL2 enrollments

Enrollment records 2

Community mental health center certification: CCN 684664

Legal name

CAMPILLO MEDICAL CORP

Certification status

Active

Provider type (POS)

Community mental health center

Participating since

Feb 14, 2024

Last certification

Dec 6, 2023

Ownership / control type

For profit – individual

Facility address

6583 SW 39TH Ter
Miami, FL 33155

Locations

Networks

• HealthSun Health Plans Network

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Eric R Campillo-Juig, APRN

  • Mental Health Counselor
  • Miami, FL
  • NPI 1205039005

  Multi-Specialty

  Medicare reassignment NPD Authorized official
• Kalvin Kunal Kapoor, D.O

  • Psychiatry Physician
  • Miami, FL
  • NPI 1861829392
  Medicare reassignment NPD
• Hamlet R Hassan, MD

  • Psychiatry Physician
  • Miami, FL
  • NPI 1326128323
  Care Compare group
• Jorge Luis Jorge, MD

  • Psychiatry Physician
  • Miami, FL
  • NPI 1366949737
  Care Compare group

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

{
    "created_epoch": "1496016000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1610064000000",
    "number": "1831627371",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6583 SW 39TH TER",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331554821",
            "telephone_number": "786-615-3187",
            "fax_number": "786-756-1010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6583 SW 39TH TER",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331554821",
            "telephone_number": "786-615-3187",
            "fax_number": "786-756-1010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAMPILLO MEDICAL CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-05-29",
        "last_updated": "2021-01-08",
        "certification_date": "2021-01-08",
        "status": "A",
        "authorized_official_last_name": "CAMPILLO-JUIG",
        "authorized_official_first_name": "ERIC",
        "authorized_official_title_or_position": "CLINICAL DIRECTOR",
        "authorized_official_telephone_number": "305-300-5551",
        "authorized_official_credential": "APRN, LHHC"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QC1500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Community Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "105-282-500",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CAMPILLO MEDICAL CORP",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Lloyd Lonnie Camper
• Christiam Campero, MD
• Madelainy Campes
• Mileini Campez-Pardo, PHD
• Campillo Medical Center Inc
• Campillo Medical Inc
• Dayana Campillo Ruiz
• Eric R Campillo-Juig, APRN
• Elizabeth Campillo
• Luis M Campillo, MD

• Community Health Clinic/Center in Miami, FL
• Providers in Miami, FL by specialty
• Community Health Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.