Provider Demographics
NPI:1922715978
Name:CACERES DE ARMAS, LUIS ALAIN (F10221382)
Entity Type:Individual
Prefix:
First Name:LUIS
Middle Name:ALAIN
Last Name:CACERES DE ARMAS
Suffix:
Gender:M
Credentials:F10221382
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24866 SW 107 AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33032
Mailing Address - Country:US
Mailing Address - Phone:786-326-8723
Mailing Address - Fax:305-827-2819
Practice Address - Street 1:15190 SW 136TH ST STE 26-27
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33196-2604
Practice Address - Country:US
Practice Address - Phone:786-701-3109
Practice Address - Fax:305-827-2819
Is Sole Proprietor?:No
Enumeration Date:2022-10-31
Last Update Date:2022-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLF10221382363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily