Provider Demographics
NPI:1982303178
Name:CAMACHO, MILITZA
Entity type:Individual
Prefix:
First Name:MILITZA
Middle Name:
Last Name:CAMACHO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:MILITZA
Other - Middle Name:ISABEL
Other - Last Name:CAMACHO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MLS (AMT)
Mailing Address - Street 1:27865 SW 133RD PATH
Mailing Address - Street 2:
Mailing Address - City:HOMESTEAD
Mailing Address - State:FL
Mailing Address - Zip Code:33032-8252
Mailing Address - Country:US
Mailing Address - Phone:305-399-9565
Mailing Address - Fax:
Practice Address - Street 1:27865 SW 133RD PATH
Practice Address - Street 2:
Practice Address - City:HOMESTEAD
Practice Address - State:FL
Practice Address - Zip Code:33032-8252
Practice Address - Country:US
Practice Address - Phone:305-399-9565
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-27
Last Update Date:2023-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSU42350246QM0706X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246QM0706XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, PathologyMedical Technologist