Healthcare Provider Details

I. General information

NPI: 1699686659
Provider Name (Legal Business Name): MICHELLE A CABRAL
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/16/2026
Last Update Date: 09/16/2026
Certification Date: 09/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

725 RESERVOIR AVE
CRANSTON RI
02910-4448
US

IV. Provider business mailing address

725 RESERVOIR AVE STE 7
CRANSTON RI
02910-4450
US

V. Phone/Fax

Practice location:
  • Phone: 401-943-8835
  • Fax:
Mailing address:
  • Phone: 401-943-8835
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License NumberPTA00526
License Number StateRI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: