MEDICARE: DR. NICOLAS OCTAVIO CABRERO-MUNIZ M.D.

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	208D00000X	General Practice Physician	6814	PR

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1528266376
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. NICOLAS OCTAVIO CABRERO-MUNIZ M.D.

Provider Business Mailing Address
First Line	:	10524 MOSS PARK RD
Second Line	:	SUITE 204-169
City	:	ORLANDO
State	:	FL
Zip	:	32832-5898
Country	:	US
Telephone Number	:	787-565-9765
Fax Number	:

Provider Business Practice Location Address
First Line	:	3100 CONWAY RD
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32812-7331
Country	:	US
Telephone Number	:	855-226-6633
Fax Number	:

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

Provider Enumeration Date	:	07/03/2007
Last Update Date	:	10/26/2022

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