Provider Demographics
NPI:1639501620
Name:CABALLERO, LOURDES (PMHNP, FNP, FEP)
Entity Type:Individual
Prefix:MS
First Name:LOURDES
Middle Name:
Last Name:CABALLERO
Suffix:
Gender:F
Credentials:PMHNP, FNP, FEP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9109 SW 151ST CT
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33196-1348
Mailing Address - Country:US
Mailing Address - Phone:786-468-5386
Mailing Address - Fax:
Practice Address - Street 1:19000 SW 377TH ST
Practice Address - Street 2:
Practice Address - City:HOMESTEAD
Practice Address - State:FL
Practice Address - Zip Code:33034-6407
Practice Address - Country:US
Practice Address - Phone:786-349-6271
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-01
Last Update Date:2021-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9339471363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily