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General NPI Number Information
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NPI Number | 1598262115
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Entity Type | Individual
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Provider Name | GINA CAROLINA DOMINGO CABREJA M.D.
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Gender | Female
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Dates
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Enumeration Date | 04/10/2018
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Last Update Date | 01/04/2023
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Provider Practice Location Address
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Address Line | 1200 S PINE ISLAND RD STE 350
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City | PLANTATION
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State | FL
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Zip | 33324-4409
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Country | US
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Telephone | 305-223-2000
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Fax | 305-227-5556
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Provider Business Mailing Address
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Address Line | 6400 SHAFER CT STE 700
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City | ROSEMONT
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State | IL
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Zip | 60018-4989
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Country | US
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Telephone | 346-376-1702
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Fax | 224-532-2780
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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 | ME147267
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 207QH0002X
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Taxonomy Name | Hospice and Palliative Medicine (Family Medicine) Physician
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License Number | ME147267
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License Number State | FL
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