Provider Demographics
NPI:1902385776
Name:CABALLERO RODRIGUEZ, JOSE CARLOS
Entity type:Individual
Prefix:
First Name:JOSE
Middle Name:CARLOS
Last Name:CABALLERO RODRIGUEZ
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 1:14203 SW 145TH PL
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33186-6787
Mailing Address - Country:US
Mailing Address - Phone:786-413-7347
Mailing Address - Fax:
Practice Address - Street 1:14203 SW 145TH PL
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33186-6787
Practice Address - Country:US
Practice Address - Phone:786-413-7347
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-12
Last Update Date:2025-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11041267363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily