Provider Demographics
NPI:1730580366
Name:INCEPTION HEALTHCARE SOLUTIONS LLC
Entity type:Organization
Organization Name:INCEPTION HEALTHCARE SOLUTIONS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT AND CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:JULIO
Authorized Official - Middle Name:LUIS
Authorized Official - Last Name:CAMACHO
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:561-232-4519
Mailing Address - Street 1:14701 BARTRAM PARK BLVD UNIT 1118
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32258-5296
Mailing Address - Country:US
Mailing Address - Phone:561-232-4519
Mailing Address - Fax:
Practice Address - Street 1:14701 BARTRAM PARK BLVD UNIT 1118
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32258-5296
Practice Address - Country:US
Practice Address - Phone:561-232-4519
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-09-15
Last Update Date:2014-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS43223261QH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1285929604OtherNPI