MEDICARE: AMBER VICTORIA CABRERA

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	363A00000X	Physician Assistant

General Provider Information

NPI Number	:	1306624465
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMBER VICTORIA CABRERA

Provider Business Mailing Address
First Line	:	374 CONCORD ST
Second Line	:
City	:	ALPHARETTA
State	:	GA
Zip	:	30009-4001
Country	:	US
Telephone Number	:	770-570-2950
Fax Number	:

Provider Business Practice Location Address
First Line	:	374 CONCORD ST
Second Line	:
City	:	ALPHARETTA
State	:	GA
Zip	:	30009-4001
Country	:	US
Telephone Number	:	770-570-2950
Fax Number	:

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

Provider Enumeration Date	:	09/20/2023
Last Update Date	:	09/20/2023

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Directions to “ AMBER VICTORIA CABRERA ” Practice Location

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