Healthcare Provider Details

I. General information

NPI: 1275452625
Provider Name (Legal Business Name): KEYRI CABALLERO GONZALEZ APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/10/2026
Last Update Date: 07/10/2026
Certification Date: 07/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2749 FLUSHING DR
APOPKA FL
32703-0069
US

IV. Provider business mailing address

2749 FLUSHING DR
APOPKA FL
32703-0069
US

V. Phone/Fax

Practice location:
  • Phone: 786-774-6002
  • Fax:
Mailing address:
  • Phone: 786-774-6002
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number11049071
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: