Provider Demographics
NPI:1184604936
Name:CAVERO-RANKIN, MARIA ANTONIETA (MD)
Entity type:Individual
Prefix:DR
First Name:MARIA
Middle Name:ANTONIETA
Last Name:CAVERO-RANKIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4304 HIGHLAND PARK BLVD
Mailing Address - Street 2:
Mailing Address - City:LAKELAND
Mailing Address - State:FL
Mailing Address - Zip Code:33813-1647
Mailing Address - Country:US
Mailing Address - Phone:863-644-9398
Mailing Address - Fax:863-644-9354
Practice Address - Street 1:4304 HIGHLAND PARK BLVD
Practice Address - Street 2:
Practice Address - City:LAKELAND
Practice Address - State:FL
Practice Address - Zip Code:33813-1647
Practice Address - Country:US
Practice Address - Phone:863-644-9398
Practice Address - Fax:863-644-9354
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME73729174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL42690OtherBLUE CROSS BLUE SHIELD
FL1205587OtherUNITED HEALTHCARE
FL208101OtherSTAYWELL HMO
FL208101OtherHEALTHEASE HMO
FL210529OtherAMERIGROUP HMO
FL5484604OtherAETNA
FL210529OtherAMERIGROUP HMO