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General NPI Number Information
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NPI Number | 1073069159
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Entity Type | Organization
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Legal Business Name | CACERES SPECIALIZED GYNECOLOGY, LLC
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Dates
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Enumeration Date | 08/29/2016
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Last Update Date | 04/17/2025
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Provider Practice Location Address
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Address Line | 1136 CYPRESS GLEN CIR
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City | KISSIMMEE
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State | FL
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Zip | 34741-7559
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Country | US
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Telephone | 407-392-2777
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Fax | 407-605-5999
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Provider Business Mailing Address
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Address Line | 15502 STONEYBROOK WEST PKWY SUITE 104-241
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City | WINTER GARDEN
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State | FL
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Zip | 34787-4767
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Country | US
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Telephone | 321-286-6222
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Fax |
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Authorized Official
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Title or Position | PRESIDENT/OWNER
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Name | DR. AILEEN CACERES
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Credential | MD
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Telephone | 321-286-6222
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207VG0400X
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Taxonomy Name | Gynecology Physician
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License Number | ME98869
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License Number State | FL
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