Provider Demographics
NPI:1861478141
Name:CACHO, WILLIE (MD, MBA)
Entity Type:Individual
Prefix:DR
First Name:WILLIE
Middle Name:
Last Name:CACHO
Suffix:
Gender:M
Credentials:MD, MBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 MACARTHUR CSWY
Mailing Address - Street 2:
Mailing Address - City:MIAMI BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33139-5101
Mailing Address - Country:US
Mailing Address - Phone:305-535-4535
Mailing Address - Fax:305-535-4413
Practice Address - Street 1:CG-1122 USCG CMDT
Practice Address - Street 2:2100 2ND ST., SW, SUITE 5314
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20593-0001
Practice Address - Country:US
Practice Address - Phone:305-535-4535
Practice Address - Fax:305-535-4413
Is Sole Proprietor?:No
Enumeration Date:2005-12-19
Last Update Date:2016-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR08009207Q00000X
NC39402207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
20633OtherBCBS
20633OtherBCBS