Provider Demographics
NPI:1194394262
Name:CAIVEAU, FREDERIC (LMT)
Entity Type:Individual
Prefix:MR
First Name:FREDERIC
Middle Name:
Last Name:CAIVEAU
Suffix:
Gender:M
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9202 NW 81ST PL
Mailing Address - Street 2:
Mailing Address - City:TAMARAC
Mailing Address - State:FL
Mailing Address - Zip Code:33321-1421
Mailing Address - Country:US
Mailing Address - Phone:561-418-0033
Mailing Address - Fax:
Practice Address - Street 1:9202 NW 81ST PL
Practice Address - Street 2:
Practice Address - City:TAMARAC
Practice Address - State:FL
Practice Address - Zip Code:33321-1421
Practice Address - Country:US
Practice Address - Phone:561-418-0033
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-22
Last Update Date:2021-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA91929225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty