Provider Demographics
NPI:1730953555
Name:CABALLERO, VINCENT DAVID
Entity type:Individual
Prefix:
First Name:VINCENT
Middle Name:DAVID
Last Name:CABALLERO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11380 PROSPERITY FARMS RD
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33410-3474
Mailing Address - Country:US
Mailing Address - Phone:787-366-9489
Mailing Address - Fax:
Practice Address - Street 1:11380 PROSPERITY FARMS RD
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33410-3474
Practice Address - Country:US
Practice Address - Phone:787-366-9489
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-11-13
Last Update Date:2023-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH14754111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor