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General NPI Number Information
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NPI Number | 1760708002
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Entity Type | Individual
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Provider Name | ELLIOT W. CAUBLE MD
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Gender | Male
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Dates
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Enumeration Date | 04/12/2010
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Last Update Date | 03/14/2022
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Provider Practice Location Address
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Address Line | 10141 BIG BEND RD SUITE 206
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City | RIVERVIEW
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State | FL
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Zip | 33578-7419
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Country | US
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Telephone | 813-397-1274
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Fax | 813-397-1271
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Provider Business Mailing Address
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Address Line | 10141 BIG BEND RD STE 206
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City | RIVERVIEW
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State | FL
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Zip | 33578-7422
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Country | US
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Telephone | 813-397-1274
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Fax | 813-605-6003
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 164638
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | ME124576
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License Number State | FL
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