Provider Demographics
NPI:1528053063
Name:CACERES, LUIS RODRIGUEZ III (DO)
Entity type:Individual
Prefix:DR
First Name:LUIS
Middle Name:RODRIGUEZ
Last Name:CACERES
Suffix:III
Gender:M
Credentials:DO
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Mailing Address - Street 1:9290 SW 72ND ST
Mailing Address - Street 2:STE 103
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33173-3236
Mailing Address - Country:US
Mailing Address - Phone:305-271-8383
Mailing Address - Fax:305-271-8448
Practice Address - Street 1:9260 SW 72ND ST
Practice Address - Street 2:SUITE 115
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33173-3255
Practice Address - Country:US
Practice Address - Phone:305-271-8383
Practice Address - Fax:305-271-8448
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-12
Last Update Date:2021-07-07
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Provider Licenses
StateLicense IDTaxonomies
FLOS7681207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL261435900Medicaid
FLH39368Medicare UPIN