Provider Demographics
NPI:1275254476
Name:CABALLERO, FABIOLA
Entity Type:Individual
Prefix:MRS
First Name:FABIOLA
Middle Name:
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 1:409 W 20TH ST
Mailing Address - Street 2:
Mailing Address - City:SANFORD
Mailing Address - State:FL
Mailing Address - Zip Code:32771-3836
Mailing Address - Country:US
Mailing Address - Phone:321-217-9183
Mailing Address - Fax:
Practice Address - Street 1:409 W 20TH ST
Practice Address - Street 2:
Practice Address - City:SANFORD
Practice Address - State:FL
Practice Address - Zip Code:32771-3836
Practice Address - Country:US
Practice Address - Phone:321-217-9183
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-06
Last Update Date:2022-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care ProviderGroup - Single Specialty