Healthcare Provider Details

I. General information

NPI: 1184183766
Provider Name (Legal Business Name): RIGEL ALBERTO CACERES
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/13/2019
Last Update Date: 03/13/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1395 CENTER DR GAINESVILLE FL 32610
GAINESVILLE FL
32610-0001
US

IV. Provider business mailing address

3100 JODHPURS LN APT 3403
ORLANDO FL
32837-4873
US

V. Phone/Fax

Practice location:
  • Phone: 352-273-5800
  • Fax:
Mailing address:
  • Phone: 407-350-1969
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: