Provider Demographics
NPI:1881674745
Name:CACERES, HECTOR L (MD)
Entity Type:Individual
Prefix:DR
First Name:HECTOR
Middle Name:L
Last Name:CACERES
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:HECTOR
Other - Middle Name:L
Other - Last Name:CACERES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 802
Mailing Address - Street 2:
Mailing Address - City:CAGUAS
Mailing Address - State:PR
Mailing Address - Zip Code:00726-0802
Mailing Address - Country:US
Mailing Address - Phone:787-744-7410
Mailing Address - Fax:787-743-5157
Practice Address - Street 1:MUNOZ RIVERA ST #2
Practice Address - Street 2:SUITE 212
Practice Address - City:CAGUAS
Practice Address - State:PR
Practice Address - Zip Code:00725
Practice Address - Country:US
Practice Address - Phone:787-744-7410
Practice Address - Fax:787-743-5157
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-18
Last Update Date:2011-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR4449207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
63404OtherBLUE CROSS
24582OtherSSS
24582Medicare ID - Type Unspecified
24582OtherSSS