Provider Demographics
NPI:1033301213
Name:CABALLERO DE PARIS INC
Entity Type:Organization
Organization Name:CABALLERO DE PARIS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RICARDO
Authorized Official - Middle Name:
Authorized Official - Last Name:CAULA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-269-5155
Mailing Address - Street 1:6722 W FLAGLER ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33144-2924
Mailing Address - Country:US
Mailing Address - Phone:305-269-5155
Mailing Address - Fax:305-269-5167
Practice Address - Street 1:6722 W FLAGLER ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33144-2924
Practice Address - Country:US
Practice Address - Phone:305-269-5155
Practice Address - Fax:305-269-5167
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-13
Last Update Date:2008-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332BP3500X
FLPH229833336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No332BP3500XSuppliersDurable Medical Equipment & Medical SuppliesParenteral & Enteral Nutrition
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL=========OtherEIN
FL=========OtherEIN