Provider Demographics
NPI:1972183028
Name:CAO, ROBERTO III (MS, LAT, ATC, NREMT)
Entity type:Individual
Prefix:MR
First Name:ROBERTO
Middle Name:
Last Name:CAO
Suffix:III
Gender:M
Credentials:MS, LAT, ATC, NREMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8265 NW 41ST ST APT 403
Mailing Address - Street 2:
Mailing Address - City:DORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33166-6285
Mailing Address - Country:US
Mailing Address - Phone:305-331-2215
Mailing Address - Fax:
Practice Address - Street 1:1800 INTEGRITY WAY UNIT 201
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40220-3876
Practice Address - Country:US
Practice Address - Phone:305-331-2215
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-13
Last Update Date:2024-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAAT0043412255A2300X
GAE036690146N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer
No146N00000XEmergency Medical Service ProvidersEmergency Medical Technician, Basic