Provider Demographics
NPI:1982788147
Name:CABALLES, MARCIANA JINGCO (MSN, ARNP-BC)
Entity Type:Individual
Prefix:MRS
First Name:MARCIANA
Middle Name:JINGCO
Last Name:CABALLES
Suffix:
Gender:F
Credentials:MSN, ARNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:45 NW 95TH ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI SHORES
Mailing Address - State:FL
Mailing Address - Zip Code:33150-1709
Mailing Address - Country:US
Mailing Address - Phone:305-758-1320
Mailing Address - Fax:
Practice Address - Street 1:1201 N.W. 16TH ST.
Practice Address - Street 2:B639
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33125
Practice Address - Country:US
Practice Address - Phone:305-575-7000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1014042363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health