MEDICARE: ANTHONY RAUL CABIESES

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	172V00000X	Community Health Worker

General Provider Information

NPI Number	:	1114610367
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANTHONY RAUL CABIESES

Provider Business Mailing Address
First Line	:	11808 HUGGINS DR
Second Line	:
City	:	SILVER SPRING
State	:	MD
Zip	:	20902-2345
Country	:	US
Telephone Number	:	240-273-5136
Fax Number	:

Provider Business Practice Location Address
First Line	:	10720 COLUMBIA PIKE
Second Line	:
City	:	SILVER SPRING
State	:	MD
Zip	:	20901-4437
Country	:	US
Telephone Number	:	301-754-7000
Fax Number	:

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

Provider Enumeration Date	:	06/01/2023
Last Update Date	:	06/01/2023

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