Healthcare Provider Details

I. General information

NPI: 1437017092
Provider Name (Legal Business Name): CARLOS CAICEDO DMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/13/2026
Last Update Date: 09/22/2026
Certification Date: 09/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

344 WILSHIRE BLVD
CASSELBERRY FL
32707-5370
US

IV. Provider business mailing address

10824 TILSTON PT
ORLANDO FL
32832-6148
US

V. Phone/Fax

Practice location:
  • Phone: 321-204-3545
  • Fax:
Mailing address:
  • Phone: 786-457-2827
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License NumberDN32525
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: