Provider Demographics
NPI:1083658272
Name:CABRERA MARTIN HEALTHCARE INC
Entity Type:Organization
Organization Name:CABRERA MARTIN HEALTHCARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:LUIS
Authorized Official - Middle Name:M
Authorized Official - Last Name:CABRERA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-722-3944
Mailing Address - Street 1:PMB 117
Mailing Address - Street 2:1353 ST #19 GARDEN HILLS
Mailing Address - City:GUAYNABO
Mailing Address - State:PR
Mailing Address - Zip Code:00966-0001
Mailing Address - Country:US
Mailing Address - Phone:787-722-3944
Mailing Address - Fax:
Practice Address - Street 1:CALLE MANUEL PAVIA 611
Practice Address - Street 2:SUITE 213
Practice Address - City:SANTURCE
Practice Address - State:PR
Practice Address - Zip Code:00910
Practice Address - Country:US
Practice Address - Phone:787-722-3944
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-16
Last Update Date:2014-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
84792Medicare ID - Type Unspecified
PR0084792Medicare PIN