Provider Demographics
NPI:1265017776
Name:CABALLERO, MARIA CABALLERO DEL CARMEN
Entity Type:Individual
Prefix:
First Name:MARIA CABALLERO
Middle Name:DEL CARMEN
Last Name:CABALLERO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4929 E 8TH CT
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33013-1701
Mailing Address - Country:US
Mailing Address - Phone:786-212-3787
Mailing Address - Fax:
Practice Address - Street 1:1521 NW 54TH ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33142-3807
Practice Address - Country:US
Practice Address - Phone:786-594-0000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-16
Last Update Date:2021-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist