MEDICARE: MIGUEL ANGEL 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	390200000X	Student in an Organized Health Care Education/Training Program
2	207P00000X	Emergency Medicine Physician	19595	PR

General Provider Information

NPI Number	:	1750542817
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MIGUEL ANGEL CABRERA M.D.

Provider Business Mailing Address
First Line	:	14TH ST. APT. B-204
Second Line	:	QUINTAS DE CUPEY
City	:	SAN JUAN
State	:	PR
Zip	:	00926
Country	:	US
Telephone Number	:	787-529-5121
Fax Number	:

Provider Business Practice Location Address
First Line	:	1600 GRANBY ST APT 245
Second Line	:
City	:	NORFOLK
State	:	VA
Zip	:	23510-2642
Country	:	US
Telephone Number	:	787-529-5121
Fax Number	:

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

Provider Enumeration Date	:	06/21/2008
Last Update Date	:	04/10/2018

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