Provider Demographics
NPI:1194041236
Name:CABALLERO-RAMOS, CARLA IRIS (OD)
Entity Type:Individual
Prefix:DR
First Name:CARLA
Middle Name:IRIS
Last Name:CABALLERO-RAMOS
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5142 HOOK HOLLOW CIR
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32837-4913
Mailing Address - Country:US
Mailing Address - Phone:407-583-9372
Mailing Address - Fax:407-377-7645
Practice Address - Street 1:5991 S GOLDENROD RD
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32822-8775
Practice Address - Country:US
Practice Address - Phone:844-433-9337
Practice Address - Fax:407-377-7645
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-14
Last Update Date:2024-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYTUV008080152W00000X
FLOPC4897152W00000X
PR675152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL652833Medicaid