Provider Demographics
NPI:1093301582
Name:CABALLERO PEREZ, JULIO CESAR (CBHCM-P)
Entity Type:Individual
Prefix:
First Name:JULIO
Middle Name:CESAR
Last Name:CABALLERO PEREZ
Suffix:
Gender:M
Credentials:CBHCM-P
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25779 SW 144TH AVE
Mailing Address - Street 2:
Mailing Address - City:HOMESTEAD
Mailing Address - State:FL
Mailing Address - Zip Code:33032-5314
Mailing Address - Country:US
Mailing Address - Phone:813-693-8142
Mailing Address - Fax:
Practice Address - Street 1:1801 CORAL WAY
Practice Address - Street 2:STE 320
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33145-2784
Practice Address - Country:US
Practice Address - Phone:786-615-4831
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-18
Last Update Date:2023-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL108208600Medicaid