Healthcare Provider Details

I. General information

NPI: 1255318986
Provider Name (Legal Business Name): ANTONIO DE THOMAS-CABRERA M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 12/23/2005
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 AVE FD ROOSEVELT CLINICA LAS AMERICAS
SAN JUAN PR
00918-2129
US

IV. Provider business mailing address

400 AVE FD ROOSEVELT CLINICA LAS AMERICAS
SAN JUAN PR
00918-2129
US

V. Phone/Fax

Practice location:
  • Phone: 787-765-7713
  • Fax: 787-250-7967
Mailing address:
  • Phone: 787-765-7713
  • Fax: 787-250-7967

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number011026
License Number StatePR
# 2
Primary TaxonomyY
Taxonomy Code2085U0001X
TaxonomyDiagnostic Ultrasound Physician
License Number011026
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: