Provider Demographics
NPI:1235195165
Name:CAOS, ANTONIO (MD)
Entity Type:Individual
Prefix:
First Name:ANTONIO
Middle Name:
Last Name:CAOS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:407 S WASHINGTON AVE STE 1
Mailing Address - Street 2:
Mailing Address - City:TITUSVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32796-3500
Mailing Address - Country:US
Mailing Address - Phone:321-385-0884
Mailing Address - Fax:321-385-9578
Practice Address - Street 1:407 S WASHINGTON AVE STE 1
Practice Address - Street 2:
Practice Address - City:TITUSVILLE
Practice Address - State:FL
Practice Address - Zip Code:32796-3500
Practice Address - Country:US
Practice Address - Phone:321-385-0884
Practice Address - Fax:321-385-9578
Is Sole Proprietor?:No
Enumeration Date:2006-04-20
Last Update Date:2020-02-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME36993207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NMD62171Medicare UPIN