Individual
CARLOS CABALLERO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
1921 WALDEMERE ST STE 310, SARASOTA, FL 34239
(941) 917-5400
(941) 917-5420
Mailing address
PO BOX 863407, ORLANDO, FL 32886-3407
(941) 917-2600
(941) 917-7884
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA 9109229
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
398574
AVMED
FL
01
—
4038126
AETNA
FL
01
—
7231569
CIGNA
FL
01
—
B7E7N
BCBS
FL
01
—
P01619306
RR MEDICARE
FL
01
—
P1037507
FREEDOM
FL
01
—
P972734
OPTIMUM
FL
Enumeration date
01/13/2016
Last updated
06/21/2018
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