Physician Compare National (NPI:1255310074)

HEALTHCARE PROVIDER: CARMEN MILAGROS CABRERA CRESPO MD

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1255310074
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	1254300833
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20180518001815
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	CABRERA
	Individual professional last name
Provider First Name	CARMEN
	Individual professional first name
Provider Middle Name	MILAGROS
	Individual professional middle name
Provider Gender	F
	The provider's gender if the provider is a person.
Provider Credential Text	MD
	The abbreviations for professional degrees or credentials used or held by the provider, if the provider is an individual. Examples are MD, DDS, CSW, CNA, AA, NP, RNA, or PSY. These credential designations will not be verified by NPS.

Medical School Information
Medical School Name	OTHER
	Individual professional's medical school
Graduation Year	1991
	Individual professional's medical school graduation year
Primary Specialty	GENERAL PRACTICE
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Organization Legal Name	MEDICAL HOME ALLIANCE, LLC
	Legal name of the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Group Practice PAC ID	6406096536
	Unique Group Practice ID assigned by PECOS to the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Number of Group Practice members	50
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	199 AVE K SE
	Group Practice or individual's line 1 address
City	WINTER HAVEN
	Group Practice or individual's city
State	FL
	Group Practice or individual's state
Zip Code	338803944
	Group Practice or individual's zip code (9 digits when available)
Phone Number	5635881424
	Phone number is listed only when there is a single phone number available for the practice location address

Hospital(s) Affiliation Information
Professional Accepts Medicare Assignment	Y