MEDICARE: CAMILO L. CABRERA M.D.

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	207R00000X	Internal Medicine Physician	ME 85354	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

General Provider Information

NPI Number	:	1124025481
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CAMILO L. CABRERA M.D.

Provider Business Mailing Address
First Line	:	7005 CORTEZ RD W
Second Line	:
City	:	BRADENTON
State	:	FL
Zip	:	34210-2509
Country	:	US
Telephone Number	:	941-752-2700
Fax Number	:	941-752-2730

Provider Business Practice Location Address
First Line	:	7005 CORTEZ RD W
Second Line	:
City	:	BRADENTON
State	:	FL
Zip	:	34210-2509
Country	:	US
Telephone Number	:	941-752-2700
Fax Number	:	941-752-2730

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

Provider Enumeration Date	:	07/01/2005
Last Update Date	:	01/28/2022

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