Individual
DIMITRI CORDOVA CABALLERO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
14770 SW 176TH ST, MIAMI, FL 33187-6714
(786) 366-7785
Mailing address
2001 PALM BEACH LAKES BLVD STE 400, WEST PALM BEACH, FL 33409-6516
(561) 420-8544
(561) 712-8886
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
ACN1021
FL
208D00000X
General Practice Physician
19456
PR
Other
Enumeration date
05/17/2016
Last updated
01/22/2019
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