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General NPI Number Information
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NPI Number | 1275761975
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Entity Type | Individual
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Provider Name | AGUSTIN CABALLERO- PEREZ M.D.
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Gender | Male
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Dates
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Enumeration Date | 07/01/2009
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Last Update Date | 10/11/2017
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Provider Practice Location Address
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Address Line | DA19 CALLE 167 JARDINES OF COUNTRY CLUB
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City | CAROLINA
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State | PR
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Zip | 00983-2158
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Country | US
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Telephone | 787-607-5848
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Fax |
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Provider Business Mailing Address
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Address Line | 6675 WESTWOOD BLVD STE 475
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City | ORLANDO
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State | FL
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Zip | 32821-6027
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Country | US
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Telephone | 407-845-0330
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Fax | 888-972-1752
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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 | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | 17642
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License Number State | PR
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Taxonomy #2
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | ACN958
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License Number State | FL
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