Provider Demographics
NPI:1770811390
Name:CARCASES, HERIBERTO
Entity type:Individual
Prefix:
First Name:HERIBERTO
Middle Name:
Last Name:CARCASES
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6560 W 12TH CT
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33012-6329
Mailing Address - Country:US
Mailing Address - Phone:786-395-8106
Mailing Address - Fax:
Practice Address - Street 1:6560 W 12TH CT
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33012-6329
Practice Address - Country:US
Practice Address - Phone:786-395-8106
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-19
Last Update Date:2009-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst