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:
Health care specialties
Specialty | Code | License # | 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 7 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.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1194168641 | NPPES |
Florida | MEDICAID | 100014500 |
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