Basic Information
| Provider Information | |||||||||
| NPI: | 1831157163 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | CABALLERO-VALIENTE | ||||||||
| FirstName: | BARUCH | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | |||||||||
| OtherFirstName: | |||||||||
| OtherMiddleName: | |||||||||
| OtherNamePrefix: | |||||||||
| OtherNameSuffix: | |||||||||
| OtherCredential: | |||||||||
| OtherLastNameType: | |||||||||
| Mailing Information | |||||||||
| Address1: | PO BOX 79061 | ||||||||
| Address2: | |||||||||
| City: | CAROLINA | ||||||||
| State: | PR | ||||||||
| PostalCode: | 009849061 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7872005413 | ||||||||
| FaxNumber: | 7874747346 | ||||||||
| Practice Location | |||||||||
| Address1: | OFICINA 204 PARADA 22 NUM 328 AVE. JOSE DE DIEGO | ||||||||
| Address2: | EDIFICIO CHEVERE | ||||||||
| City: | SANTURCE | ||||||||
| State: | PR | ||||||||
| PostalCode: | 00901 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7872005413 | ||||||||
| FaxNumber: | 7874747346 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/03/2006 | ||||||||
| LastUpdateDate: | 04/29/2013 | ||||||||
| NPIDeactivationReasonCode: | |||||||||
| NPIDeactivationDate: | |||||||||
| NPIReactivationDate: | |||||||||
| ProviderGenderCode: | M | ||||||||
| AuthorizedOfficialLastName: | |||||||||
| AuthorizedOfficialFirstName: | |||||||||
| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | |||||||||
| AuthorizedOfficialTelephone: | |||||||||
| IsSoleProprietor: | Y | ||||||||
| IsOrganizationSubpart: | |||||||||
| ParentOrganizationLBN: | |||||||||
| AuthorizedOfficialNamePrefix: | |||||||||
| AuthorizedOfficialNameSuffix: | |||||||||
| AuthorizedOfficialCredential: | |||||||||
| NPICertificationDate: | |||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 174400000X | 006689 | PR | N | Other Service Providers | Specialist | 207R00000X | 6689 | PR | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207RC0000X | 6689 | PR | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Cardiovascular Disease |
No ID Information.