MEDICARE: DR. MOISES CABRERA D.D.S.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist	DN 15114	FL

General Provider Information

NPI Number	:	1326196163
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MOISES CABRERA D.D.S.

Provider Business Mailing Address
First Line	:	101 E 50TH PL
Second Line	:
City	:	HIALEAH
State	:	FL
Zip	:	33013-1446
Country	:	US
Telephone Number	:
Fax Number	:	305-557-1745

Provider Business Practice Location Address
First Line	:	14609 SW 104TH ST
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33186-2905
Country	:	US
Telephone Number	:	305-388-3725
Fax Number	:	305-388-1748

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/08/2007
Last Update Date	:	07/08/2007

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