Provider Demographics
NPI:1578280475
Name:CABALLERO RODRIGUEZ, DEBORAH RHODA
Entity Type:Individual
Prefix:
First Name:DEBORAH
Middle Name:RHODA
Last Name:CABALLERO RODRIGUEZ
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 1:6700 FLORIDA AVE S, #33
Mailing Address - Street 2:
Mailing Address - City:LAKELAND
Mailing Address - State:FL
Mailing Address - Zip Code:33813-2101
Mailing Address - Country:US
Mailing Address - Phone:634-503-0678
Mailing Address - Fax:
Practice Address - Street 1:6700 FLORIDA AVE S, # 33
Practice Address - Street 2:
Practice Address - City:LAKELAND
Practice Address - State:FL
Practice Address - Zip Code:33813-2101
Practice Address - Country:US
Practice Address - Phone:863-450-3067
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-10-21
Last Update Date:2023-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11022395363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily