Provider Demographics
NPI:1093433930
Name:CABRERA RAMOS, JOHN AXEL
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:AXEL
Last Name:CABRERA RAMOS
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 1043
Mailing Address - Street 2:
Mailing Address - City:CANOVANAS
Mailing Address - State:PR
Mailing Address - Zip Code:00729-1043
Mailing Address - Country:US
Mailing Address - Phone:787-407-7666
Mailing Address - Fax:
Practice Address - Street 1:4203 CALLE MARGINAL
Practice Address - Street 2:
Practice Address - City:FAJARDO
Practice Address - State:PR
Practice Address - Zip Code:00738-3652
Practice Address - Country:US
Practice Address - Phone:787-860-1603
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-17
Last Update Date:2022-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR2427183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist