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General NPI Number Information
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NPI Number | 1215226147
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Entity Type | Individual
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Provider Name | TIMOTHY JOHN CABALLES DPM
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Gender | Male
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Dates
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Enumeration Date | 03/31/2011
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Last Update Date | 05/30/2020
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Provider Practice Location Address
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Address Line | 3735 11TH CIR SUITE 201
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City | VERO BEACH
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State | FL
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Zip | 32960-4844
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Country | US
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Telephone | 772-299-7009
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Fax |
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Provider Business Mailing Address
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Address Line | 3735 11TH CIR STE 201
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City | VERO BEACH
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State | FL
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Zip | 32960-4889
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Country | US
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Telephone | 772-299-7009
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | PO3615
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License Number State | FL
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