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General NPI Number Information
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NPI Number | 1831612993
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Entity Type | Individual
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Provider Name | AGUSTIN JOSE CABRERA GONCALVES MD
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Gender | Male
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Dates
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Enumeration Date | 07/20/2017
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Last Update Date | 08/15/2025
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Provider Practice Location Address
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Address Line | 1580 NW 10TH AVE FL 1
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City | MIAMI
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State | FL
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Zip | 33136-1013
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Country | US
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Telephone | 713-289-9023
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Fax | 305-243-6708
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Provider Business Mailing Address
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Address Line | 11788 SW 151ST PATH
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City | MIAMI
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State | FL
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Zip | 33196-2563
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Country | US
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Telephone | 713-289-9023
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Fax |
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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 | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | ME156145
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 2080P0214X
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Taxonomy Name | Pediatric Pulmonology Physician
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License Number | ME156145
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License Number State | FL
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