Healthcare Provider Details

I. General information

NPI: 1598251068
Provider Name (Legal Business Name): JOSE R CABRALES JUAN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/07/2018
Last Update Date: 08/10/2026
Certification Date: 08/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2030 S OCEAN DR APT 2121
HALLANDALE BEACH FL
33009-6616
US

IV. Provider business mailing address

2030 S OCEAN DR APT 2121
HALLANDALE BEACH FL
33009-6616
US

V. Phone/Fax

Practice location:
  • Phone: 305-215-0605
  • Fax:
Mailing address:
  • Phone: 305-215-0605
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License NumberC1-0025408
License Number StateDE
# 2
Primary TaxonomyY
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License Number181757
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: