Provider Demographics
NPI:1093986150
Name:CABRERA MEDICAL SERVICES INC
Entity Type:Organization
Organization Name:CABRERA MEDICAL SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ISRAEL
Authorized Official - Middle Name:E
Authorized Official - Last Name:CABRERA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:305-510-0471
Mailing Address - Street 1:2695 S LE JEUNE RD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:CORAL GABLES
Mailing Address - State:FL
Mailing Address - Zip Code:33134-5839
Mailing Address - Country:US
Mailing Address - Phone:305-510-0471
Mailing Address - Fax:
Practice Address - Street 1:2695 S LE JEUNE RD
Practice Address - Street 2:SUITE 200
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33134-5839
Practice Address - Country:US
Practice Address - Phone:305-510-0471
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CABRERA MEDICAL SERVICES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-03-17
Last Update Date:2011-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0064292207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL374667400Medicaid
FLK9397Medicare PIN