MEDICARE: CABRERA & CABRERA LLC

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	231H00000X	Audiologist

General Provider Information

NPI Number	:	1417617119
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CABRERA & CABRERA LLC

Provider Business Mailing Address
First Line	:	8037 CORPORATE CENTER DR STE 100
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28226-4550
Country	:	US
Telephone Number	:	704-542-3339
Fax Number	:

Provider Business Practice Location Address
First Line	:	8037 CORPORATE CENTER DR STE 100
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28226-4550
Country	:	US
Telephone Number	:	704-845-1717
Fax Number	:

Authorized Official
Title or Position	:	AUDIOLOGIST
Name	:	TOMAS CABRERA
Credential	:	AU.D
Telephone Number	:	704-542-3339

Provider Enumeration Date	:	12/21/2021
Last Update Date	:	02/14/2022

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