Provider Demographics
NPI:1508847914
Name:CARO, ROBERTO A (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBERTO
Middle Name:A
Last Name:CARO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:111 TURNER RD
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45415-3617
Mailing Address - Country:US
Mailing Address - Phone:937-275-3488
Mailing Address - Fax:937-275-3371
Practice Address - Street 1:111 TURNER RD
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45415-3617
Practice Address - Country:US
Practice Address - Phone:937-275-3488
Practice Address - Fax:937-275-3371
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-11-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35056515C208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
1440689OtherBWC
OH0696180Medicaid
OH0696180Medicaid