Provider Demographics
NPI:1093270605
Name:CABAN, JAVIER J
Entity Type:Individual
Prefix:MR
First Name:JAVIER
Middle Name:J
Last Name:CABAN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 87453
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70879-8453
Mailing Address - Country:US
Mailing Address - Phone:850-543-1829
Mailing Address - Fax:
Practice Address - Street 1:4949 STUMBERG LN
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70816-4781
Practice Address - Country:US
Practice Address - Phone:850-543-1829
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-02-07
Last Update Date:2019-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)