Provider Demographics
NPI:1073254264
Name:CABALLERO, HECTOR (MD)
Entity Type:Individual
Prefix:
First Name:HECTOR
Middle Name:
Last Name:CABALLERO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:732 W DEER LAKE DR
Mailing Address - Street 2:
Mailing Address - City:LUTZ
Mailing Address - State:FL
Mailing Address - Zip Code:33548-4270
Mailing Address - Country:US
Mailing Address - Phone:813-352-8003
Mailing Address - Fax:
Practice Address - Street 1:1919 ELM ST N
Practice Address - Street 2:
Practice Address - City:FARGO
Practice Address - State:ND
Practice Address - Zip Code:58102-2416
Practice Address - Country:US
Practice Address - Phone:813-352-8003
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-05
Last Update Date:2023-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program