Provider Demographics
NPI:1669976445
Name:CAC INTERNATIONAL GROUP, INC
Entity type:Organization
Organization Name:CAC INTERNATIONAL GROUP, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:V.PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:RAUL
Authorized Official - Middle Name:
Authorized Official - Last Name:ELVIRO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-609-8437
Mailing Address - Street 1:325 PEARSON ST
Mailing Address - Street 2:
Mailing Address - City:LEHIGH ACRES
Mailing Address - State:FL
Mailing Address - Zip Code:33974-0438
Mailing Address - Country:US
Mailing Address - Phone:305-609-8437
Mailing Address - Fax:
Practice Address - Street 1:1428 LEE BLVD
Practice Address - Street 2:
Practice Address - City:LEHIGH ACRES
Practice Address - State:FL
Practice Address - Zip Code:33936-4850
Practice Address - Country:US
Practice Address - Phone:305-609-8437
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-03-19
Last Update Date:2018-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL180187172A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes172A00000XOther Service ProvidersDriverGroup - Single Specialty