MEDICARE: DR. LUZ E CABRERA D.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	122300000X	Dentist	DN-0014538	FL

Other Identifiers

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

General Provider Information

NPI Number	:	1629242342
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LUZ E CABRERA D.M.D.

Provider Business Mailing Address
First Line	:	224 BULLARD PKWY
Second Line	:
City	:	TEMPLE TERRACE
State	:	FL
Zip	:	33617-5512
Country	:	US
Telephone Number	:	813-988-2729
Fax Number	:	813-988-8729

Provider Business Practice Location Address
First Line	:	224 E BULLARD PKWY
Second Line	:
City	:	TEMPLE TERRACE
State	:	FL
Zip	:	33617-5512
Country	:	US
Telephone Number	:	813-988-2729
Fax Number	:	813-988-8729

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

Provider Enumeration Date	:	04/14/2008
Last Update Date	:	04/14/2008

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