Provider Demographics
NPI:1932661683
Name:CABALLERO MARRERO, NATALIA MARIA (DDS)
Entity Type:Individual
Prefix:DR
First Name:NATALIA
Middle Name:MARIA
Last Name:CABALLERO MARRERO
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:196 EVEREST LN STE 1
Mailing Address - Street 2:
Mailing Address - City:ST JOHNS
Mailing Address - State:FL
Mailing Address - Zip Code:32259-4103
Mailing Address - Country:US
Mailing Address - Phone:904-584-9004
Mailing Address - Fax:
Practice Address - Street 1:196 EVEREST LN STE 1
Practice Address - Street 2:
Practice Address - City:ST JOHNS
Practice Address - State:FL
Practice Address - Zip Code:32259-4103
Practice Address - Country:US
Practice Address - Phone:904-584-9004
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-04-02
Last Update Date:2022-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL257331223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry