MEDICARE: DR. JOSE I CABRERA MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207T00000X	Neurological Surgery Physician	ME57563	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1023109477
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOSE I CABRERA MD

Provider Business Mailing Address
First Line	:	3067 TAMIAMI TRL
Second Line	:	UNIT 2
City	:	PORT CHARLOTTE
State	:	FL
Zip	:	33952-6619
Country	:	US
Telephone Number	:	941-258-3515
Fax Number	:	941-258-3519

Provider Business Practice Location Address
First Line	:	3067 TAMIAMI TRL
Second Line	:	UNIT 2
City	:	PORT CHARLOTTE
State	:	FL
Zip	:	33952-6619
Country	:	US
Telephone Number	:	941-258-3515
Fax Number	:	941-258-3519

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/28/2006
Last Update Date	:	08/03/2012

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Directions to “ DR. JOSE I CABRERA MD” Practice Location

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