Mora Herrera, Juan Camilo

Mora Herrera, Juan Camilo is an individual health care provider with primary practice located at 1600 Sw Archer Rd , Gainesville FL 32610-0254. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Pain Medicine, Student, Health Care / Student in an Organized Health Care Education/Training Program. Allopathic & Osteopathic Physicians / Pain Medicine is his primary health care specialty. Mora Herrera, Juan Camilo can be contacted via phone (352) 273-8610.

Contact Information

Primary practice address
1600 Sw Archer Rd Gainesville FL 32610-0254
Phone: (352) 273-8610
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pain Medicine 207LP2900X ME133793 Florida
Student, Health Care / Student in an Organized Health Care Education/Training Program 390200000X

Profile Details

NPI number 1194168641
LBN Legal business name Mora Herrera, Juan Camilo
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 15th, 2013
Last updated Dec 12th, 2018 - about 6 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1194168641 NPPES
Florida MEDICAID 100014500

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