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General NPI Number Information
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NPI Number | 1821131509
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Entity Type | Organization
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Legal Business Name | LUIS R. CACERES, D.O., P.A.
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Dates
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Enumeration Date | 02/14/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 9260 SW 72ND ST SUITE 115
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City | MIAMI
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State | FL
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Zip | 33173-3275
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Country | US
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Telephone | 305-271-8383
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Fax | 305-271-8448
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Provider Business Mailing Address
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Address Line | 9260 SW 72ND ST SUITE 115
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City | MIAMI
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State | FL
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Zip | 33173-3275
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Country | US
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Telephone | 305-271-8383
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Fax | 305-271-8448
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. LUIS R. CACERES III
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Credential | D.O.
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Telephone | 305-271-8383
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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 | OS7681
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License Number State | FL
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