MEDICARE: LANDER CABRERA NP

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	163W00000X	Registered Nurse	298022	AZ
2	246ZC0007X	Surgical Assistant	5420
3	146N00000X	Basic Emergency Medical Technician	E90833309	AZ
4	363LA2100X	Acute Care Nurse Practitioner	298022	AZ

General Provider Information

NPI Number	:	1588281547
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LANDER CABRERA NP

Provider Business Mailing Address
First Line	:	1840 S STAPLEY DR STE 137
Second Line	:
City	:	MESA
State	:	AZ
Zip	:	85204-6683
Country	:	US
Telephone Number	:	148-055-8374
Fax Number	:

Provider Business Practice Location Address
First Line	:	1840 S STAPLEY DR STE 137
Second Line	:
City	:	MESA
State	:	AZ
Zip	:	85204-6683
Country	:	US
Telephone Number	:	148-055-8374
Fax Number	:

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

Provider Enumeration Date	:	06/25/2020
Last Update Date	:	02/17/2026

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