Provider Demographics
NPI:1740969021
Name:CABALLERO, BEATRIZ ELENA
Entity type:Individual
Prefix:
First Name:BEATRIZ
Middle Name:ELENA
Last Name:CABALLERO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3808 SPRINGLAKE VILLAGE CT
Mailing Address - Street 2:
Mailing Address - City:KISSIMMEE
Mailing Address - State:FL
Mailing Address - Zip Code:34744-8905
Mailing Address - Country:US
Mailing Address - Phone:954-909-6010
Mailing Address - Fax:
Practice Address - Street 1:3808 SPRINGLAKE VILLAGE CT
Practice Address - Street 2:
Practice Address - City:KISSIMMEE
Practice Address - State:FL
Practice Address - Zip Code:34744-8905
Practice Address - Country:US
Practice Address - Phone:954-909-6010
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-14
Last Update Date:2023-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-21-192859106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician