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EVALEEN FAYE CACCAM MD NPI 1760403091


NPI Information

NPI: 1760403091
Provider Name: EVALEEN FAYE CACCAM, MD
Classification: Obstetrics & Gynecology - 207VG0400X
Entity Type: Individual

Specialization: Gynecology

PECOS Registration: Yes

Address:
4425 MERRIMAC AVE
JACKSONVILLE, FL
ZIP 32210
Phone: (904) 346-0050
Get Directions

Evaleen Faye Caccam, MD is a gynecology obstetrics gynecology in Jacksonville, FL with 24 years of experience. The provider is a physician who specializes in diagnosis, treatment, and management of patients with gynecologic conditions. Source: National Uniform Claim Committee Evaleen Faye Caccam, MD NPI is 1760403091. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

Education
Medical School: UNIVERSITY OF MIAMI, LM MILLER SCHOOL OF MEDICINE
Graduation Year:2000

The provider's business location address is:

4425 MERRIMAC AVE
JACKSONVILLE, FL
ZIP 32210-850
Phone: (904) 346-0050
Fax: (904) 346-0080

The NPI 1760403091 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 7/21/2006 and was last updated on 2/20/2024.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207VG0400XObstetrics & GynecologyGynecologyME89729FLORIDAYes
2207V00000XObstetrics & GynecologyME89729FLORIDANo

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1269890100MEDICAIDFLORIDA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.