Mr Rene Enrique Camacho- Cordoba, is a medicare enrolled "Social Worker - Clinical" provider in Davie, Florida. His current practice location is
3440 S University Dr, Davie, Florida. You can reach out to his office (for appointments etc.) via phone at
(954) 424-6911.
Mr Rene Enrique Camacho- Cordoba is licensed to practice in Florida (license number MH16257) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1962740027.
Healthcare Provider's Profile
| Full Name | Mr Rene Enrique Camacho- Cordoba |
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| Gender | Male |
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| Speciality | Social Worker - Clinical |
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| Location | 3440 S University Dr, Davie, Florida |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1962740027
- Provider Enumeration Date: 01/24/2013
- Last Update Date: 10/14/2019
Medicare PECOS Information:
- PECOS PAC ID: 6901324896
- Enrollment ID: I20250514002941
Medical Identifiers
Medical identifiers for Mr Rene Enrique Camacho- Cordoba such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1962740027 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | 16892 (New York) | Secondary |
| 101YM0800X | Counselor - Mental Health | MH16257 (Florida) | Secondary |
| 101YM0800X | Counselor - Mental Health | 004022 (New York) | Secondary |
| 1041C0700X | Social Worker - Clinical | MH16257 (Florida) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Mr Rene Enrique Camacho- Cordoba allows following entities to bill medicare on his behalf.
| Entity Name | Balanced Wellbeing Llc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1336513639
PECOS PAC ID: 5193021848
Enrollment ID: O20160307002587 |
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| Entity Name | A & B Counseling Services Llc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1508327628
PECOS PAC ID: 6103152269
Enrollment ID: O20190726001094 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mr Rene Enrique Camacho- Cordoba is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Mr Rene Enrique Camacho- Cordoba,
4740 N State Road 7,
Lauderdale Lakes, FL 33319-5839
Ph: (954) 486-4005 | Mr Rene Enrique Camacho- Cordoba,
3440 S University Dr,
Davie, FL 33328-2000
Ph: (954) 424-6911 |
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