Provider Demographics
NPI:1699977207
Name:DR.CAMEJO'S PRIMARY CARE AND WALK IN CLINIC
Entity type:Organization
Organization Name:DR.CAMEJO'S PRIMARY CARE AND WALK IN CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ONWER
Authorized Official - Prefix:DR
Authorized Official - First Name:LEONEL
Authorized Official - Middle Name:
Authorized Official - Last Name:CAMEJO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:813-443-5224
Mailing Address - Street 1:7015 N ARMENIA AVE
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33604-5252
Mailing Address - Country:US
Mailing Address - Phone:813-443-5224
Mailing Address - Fax:813-443-5324
Practice Address - Street 1:7015 N ARMENIA AVE
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33604-5252
Practice Address - Country:US
Practice Address - Phone:813-443-5224
Practice Address - Fax:813-443-5324
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-05
Last Update Date:2011-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLK9294Medicare ID - Type Unspecified