Provider Demographics
NPI:1073297867
Name:CABOVERDE, MARCOS JOSE (PA-C)
Entity Type:Individual
Prefix:
First Name:MARCOS
Middle Name:JOSE
Last Name:CABOVERDE
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15280 NW 79TH CT
Mailing Address - Street 2:
Mailing Address - City:MIAMI LAKES
Mailing Address - State:FL
Mailing Address - Zip Code:33016-5789
Mailing Address - Country:US
Mailing Address - Phone:305-558-3724
Mailing Address - Fax:786-907-4485
Practice Address - Street 1:18501 PINES BLVD STE 210
Practice Address - Street 2:
Practice Address - City:PEMBROKE PINES
Practice Address - State:FL
Practice Address - Zip Code:33029-1420
Practice Address - Country:US
Practice Address - Phone:954-237-2505
Practice Address - Fax:954-237-2510
Is Sole Proprietor?:No
Enumeration Date:2023-06-12
Last Update Date:2023-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant