Provider Demographics
NPI:1851625651
Name:CARO, MIGUEL
Entity Type:Individual
Prefix:MR
First Name:MIGUEL
Middle Name:
Last Name:CARO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 4061
Mailing Address - Street 2:
Mailing Address - City:FAIRVIEW
Mailing Address - State:NM
Mailing Address - Zip Code:87533-4061
Mailing Address - Country:US
Mailing Address - Phone:505-351-1456
Mailing Address - Fax:505-351-1556
Practice Address - Street 1:CR 103, BUILDING 3
Practice Address - Street 2:MANZANA CENTER
Practice Address - City:CHIMAYO
Practice Address - State:NM
Practice Address - Zip Code:87522
Practice Address - Country:US
Practice Address - Phone:505-351-1456
Practice Address - Fax:505-351-1556
Is Sole Proprietor?:No
Enumeration Date:2009-09-25
Last Update Date:2009-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor