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General NPI Number Information
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NPI Number | 1003086364
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Entity Type | Individual
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Provider Name | JASMIN R CABRERA M.D.
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Gender | Female
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Dates
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Enumeration Date | 03/03/2008
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Last Update Date | 07/14/2016
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Provider Practice Location Address
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Address Line | 3740 UTICA RIDGE RD SUITE B
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City | BETTENDORF
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State | IA
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Zip | 52722-1657
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Country | US
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Telephone | 563-344-7400
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Fax | 563-359-9395
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Provider Business Mailing Address
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Address Line | 3740 UTICA RIDGE RD SUITE B
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City | BETTENDORF
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State | IA
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Zip | 52722-1657
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Country | US
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Telephone | 563-344-7400
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Fax | 563-359-9395
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 036.119880
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License Number State | IL
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