Hector Caballero, MD

Individual provider Active NPI Student in an Organized Health Care Education/Training Program · Fargo, ND

NPI 1073254264 · NPPES record last updated Jun 12, 2023

Key facts

NPI
1073254264
Entity type
Individual (NPI type 1)
Primary specialty
Student in an Organized Health Care Education/Training Program 390200000X
Practice address
1919 Elm St N
Fargo, ND 58102-2416
Phone
(813) 352-8003
NPI assigned
Apr 5, 2022
Sex
Male
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20220701000172 FL Order and Referring Only - Internal Medicine
Practitioner - Internal Medicine
2163748971

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Doctor of Medicine

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Yes

Addresses

Primary practice location

1919 Elm St N
Fargo, ND 58102-2416

Mailing address

732 W Deer Lake Dr
Lutz, FL 33548-4270
Phone (813) 352-8003

Other providers in Fargo, ND

All providers in Fargo, ND · Student in an Organized Health Care Education/Training Program in North Dakota

Sources for this page

Verify at the official NPI Registry.