Healthcare Provider Details

I. General information

NPI: 1588281547
Provider Name (Legal Business Name): LANDER CABRERA NP
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/25/2020
Last Update Date: 03/05/2026
Certification Date: 03/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8630 E VIA DE VENTURA STE 201
SCOTTSDALE AZ
85258-3358
US

IV. Provider business mailing address

1840 S STAPLEY DR STE 137
MESA AZ
85204-6683
US

V. Phone/Fax

Practice location:
  • Phone: 480-558-3744
  • Fax:
Mailing address:
  • Phone: 148-055-8374
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number298022
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number298022
License Number StateAZ
# 3
Primary TaxonomyN
Taxonomy Code146N00000X
TaxonomyBasic Emergency Medical Technician
License NumberE90833309
License Number StateAZ
# 4
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number298022
License Number StateAZ
# 5
Primary TaxonomyN
Taxonomy Code246ZC0007X
TaxonomySurgical Assistant
License Number5420
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: