=====================================================
General NPI Number Information
=====================================================
NPI Number | 1780719245
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | PERLA CABRERA
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/23/2007
-----------------------------------------------------
Last Update Date | 07/08/2007
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | CALLE TARTAK CONDOMINIO COSTA DEL SOL APT. L6 BOX 12106
-----------------------------------------------------
City | ISLA VERDE
-----------------------------------------------------
State | PR
-----------------------------------------------------
Zip | 00979
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 787-791-3898
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | CALLE TARTAK CONDOMINIO COSTA DEL SOL APT. L6 BOX 12106
-----------------------------------------------------
City | ISLA VERDE
-----------------------------------------------------
State | PR
-----------------------------------------------------
Zip | 00979
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone |
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 183500000X
-----------------------------------------------------
Taxonomy Name | Pharmacist
-----------------------------------------------------
License Number | 1895
-----------------------------------------------------
License Number State | PR
-----------------------------------------------------