Provider Demographics
NPI:1427555630
Name:CABERTO, MARIKO (ARNP)
Entity Type:Individual
Prefix:
First Name:MARIKO
Middle Name:
Last Name:CABERTO
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2100 ALOMA AVE STE 204
Mailing Address - Street 2:
Mailing Address - City:WINTER PARK
Mailing Address - State:FL
Mailing Address - Zip Code:32792-3301
Mailing Address - Country:US
Mailing Address - Phone:214-223-6603
Mailing Address - Fax:407-644-2981
Practice Address - Street 1:2100 ALOMA AVE STE 204
Practice Address - Street 2:
Practice Address - City:WINTER PARK
Practice Address - State:FL
Practice Address - Zip Code:32792-3301
Practice Address - Country:US
Practice Address - Phone:214-223-6603
Practice Address - Fax:407-644-2981
Is Sole Proprietor?:No
Enumeration Date:2018-04-12
Last Update Date:2021-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9321162363LF0000X
FLAPRN9321162207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily