Provider Demographics
NPI:1215226147
Name:CABALLES, TIMOTHY JOHN (DPM)
Entity Type:Individual
Prefix:DR
First Name:TIMOTHY
Middle Name:JOHN
Last Name:CABALLES
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3735 11TH CIR STE 201
Mailing Address - Street 2:
Mailing Address - City:VERO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32960-4889
Mailing Address - Country:US
Mailing Address - Phone:772-299-7009
Mailing Address - Fax:
Practice Address - Street 1:3735 11TH CIR
Practice Address - Street 2:SUITE 201
Practice Address - City:VERO BEACH
Practice Address - State:FL
Practice Address - Zip Code:32960-4844
Practice Address - Country:US
Practice Address - Phone:772-299-7009
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-03-31
Last Update Date:2020-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPO3615213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery