Provider Demographics
NPI:1336127653
Name:CABALLAR GONZAGA, FLOR J (MD)
Entity type:Individual
Prefix:DR
First Name:FLOR
Middle Name:J
Last Name:CABALLAR GONZAGA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:FLOR
Other - Middle Name:J ARASA
Other - Last Name:CABALLAR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:1901 RED ROCK DR
Mailing Address - Street 2:
Mailing Address - City:GALLUP
Mailing Address - State:NM
Mailing Address - Zip Code:87301-5683
Mailing Address - Country:US
Mailing Address - Phone:505-863-7301
Mailing Address - Fax:505-863-4505
Practice Address - Street 1:1901 RED ROCK DR
Practice Address - Street 2:
Practice Address - City:GALLUP
Practice Address - State:NM
Practice Address - Zip Code:87301-5683
Practice Address - Country:US
Practice Address - Phone:505-863-7031
Practice Address - Fax:505-863-4505
Is Sole Proprietor?:No
Enumeration Date:2006-01-06
Last Update Date:2025-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM97-232084N0400X, 2084S0012X, 2084N0600X, 2084N0402X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0402XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology with Special Qualifications in Child Neurology
No2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
No2084S0012XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologySleep Medicine
No2084N0600XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyClinical Neurophysiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
85031326887301A136OtherCHAMPUS
370010516OtherRAILROAD MEDICARE
AZ386161OtherAHCCCS
201014109OtherPRESBYTERIAN HEALTH/SALUD
NMNM013076OtherBC/BS
NMQ2996Medicaid
NMPROVP12052OtherMOLINA
NM10002253OtherLOVELACE HEALTH/SALUD
201014109OtherPRESBYTERIAN HEALTH/SALUD
NM345512701Medicare ID - Type Unspecified