Provider Demographics
NPI:1396446670
Name:CABALLERO, CASEY ANN (DC)
Entity type:Individual
Prefix:
First Name:CASEY
Middle Name:ANN
Last Name:CABALLERO
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:60 CALLE MIMOSA
Mailing Address - Street 2:
Mailing Address - City:CAYEY
Mailing Address - State:PR
Mailing Address - Zip Code:00736-4881
Mailing Address - Country:US
Mailing Address - Phone:939-245-2652
Mailing Address - Fax:
Practice Address - Street 1:29 CALLE WASHINGTON STE 405
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00907-1521
Practice Address - Country:US
Practice Address - Phone:939-245-2652
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-14
Last Update Date:2023-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR894111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor