Individual provider Active NPI

David Mauricio Camacho, CRNA

  • Certified Registered Nurse Anesthetist
  • Kissimmee, FL
National Provider Identifier
1891176202
Registry record updated Jun 11, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
9294629 Issued in FL
Practice address
112 Tulpan Dr
Kissimmee, FL 34743-9559
Phone
(407) 908-8220
NPI assigned
Jun 11, 2015
Last updated
Jun 11, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 9294629 FL Primary

Addresses

Primary practice location

112 Tulpan Dr
Kissimmee, FL 34743-9559

Mailing address

112 Tulpan Dr
Kissimmee, FL 34743-9559
Phone (407) 908-8220

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150821012902 FL Practitioner - Certified Registered Nurse Anesthetist (Crna) 8325353212 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

22 Underwood St
Orlando, FL 32806-1110
Phone (954) 939-5000

2906 17TH St
Saint Cloud, FL 34769-6006
Phone (954) 939-5000

52 Underwood St
Orlando, FL 32806-1110
Phone (954) 939-5000

83 W Miller St
Orlando, FL 32806-2031
Phone (954) 939-5000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
9294629FLMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Orange County Anesthesia Associates, LLC Nurse Anesthetist, Certified Registered CurrentSince Oct 1, 2020 Accepting new patients
Anesthesia Dynamics LLC Nurse Anesthetist, Certified Registered CurrentSince Dec 2, 2019 Accepting new patients
Osceola Gastroenterology Anesthesia Associates LLC Nurse Anesthetist, Certified Registered CurrentSince Jan 23, 2019 Accepting new patients
Sheridan Healthcorp, Inc. Nurse Anesthetist, Certified Registered CurrentSince Jan 25, 2020 Accepting new patients
Anesthesiologists of Greater Orlando Inc Nurse Anesthetist, Certified Registered Current Accepting new patients
US Anesthesia Partners of Florida Inc. Nurse Anesthetist, Certified Registered CurrentSince Jun 22, 2015 Accepting new patients
Sheridan Healthcorp, Inc. CurrentSince Jan 25, 2020 Accepting new patients
Sheridan Healthcorp Inc Nurse Anesthetist, Certified Registered Current Accepting new patients
Anesthesiologists of Greater Orlando Inc Nurse Anesthetist, Certified Registered CurrentSince Aug 6, 2021 Accepting new patients
Anesthesiologists of Greater Orlando Inc Nurse Anesthetist, Certified Registered CurrentSince Aug 6, 2021 Accepting new patients

Locations

665 Del Prado Blvd S
Cape Coral, FL 33990
Phone (239) 772-3636

1900 Don Wickham Dr
Clermont, FL 34711
Phone (352) 536-8761

6412 W Gulf To Lake Hwy
Crystal River, FL 34429
Phone (352) 563-0023

1700 S 23rd St
Fort Pierce, FL 34950
Phone (772) 461-4000

4500 Newberry Rd
Gainesville, FL 32607
Phone (352) 367-2310

3621 E Forest Dr
Inverness, FL 34453
Phone (352) 563-2450

2275 N Central Ave
Kissimmee, FL 34741
Phone (407) 570-0573

715 Oak Commons Blvd
Kissimmee, FL 34741
Phone (407) 910-3071

380 Rinehart Rd
Lake Mary, FL 32746
Phone (321) 842-0550

8330 Lakewood Ranch Blvd
Lakewood Ranch, FL 34202
Phone (941) 666-8757

555 W State Road 434
Longwood, FL 32750
Phone (407) 767-1200

291 Southhall Ln
Ste 201
Maitland, FL 32751
Phone (407) 667-4388

851 Trafalgar Ct
Ste 200E
Maitland, FL 32751
Phone (321) 422-7155

11750 SW 40th St
Miami, FL 33175
Phone (305) 227-5544

100 N Dean Rd
Ste 102
Orlando, FL 32825
Phone (407) 506-0006

22 Underwood St
Orlando, FL 32806
Phone (321) 841-6263

52 Underwood St
Orlando, FL 32806
Phone (321) 841-3581

601 E Rollins St
Orlando, FL 32803
Phone (407) 303-1996

83 W Miller St
Orlando, FL 32806
Phone (321) 841-5281

9400 Turkey Lake Rd
Orlando, FL 32819
Phone (321) 843-5500

8300 Red Bug Lake Rd
Oviedo, FL 32765
Phone (407) 359-6007

2906 17th St
Saint Cloud, FL 34769
Phone (407) 425-4847

1613 NW 136th Ave
Ste 200
Sunrise, FL 33323
Phone (954) 838-2502

Organizations & group practices 10

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1433980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1433980800000",
    "number": "1891176202",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "112 TULPAN DR",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347439559",
            "telephone_number": "407-908-8220"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "112 TULPAN DR",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347439559",
            "telephone_number": "407-908-8220"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAMACHO",
        "first_name": "DAVID",
        "middle_name": "MAURICIO",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-06-11",
        "last_updated": "2015-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "FL",
            "license": "9294629",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kissimmee, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2015; 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.