Provider Demographics
NPI:1164154183
Name:HERNANDEZ CABRERA, TATIANA NATALIE (MD)
Entity Type:Individual
Prefix:DR
First Name:TATIANA
Middle Name:NATALIE
Last Name:HERNANDEZ CABRERA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:HC 59 BOX 6904
Mailing Address - Street 2:
Mailing Address - City:AGUADA
Mailing Address - State:PR
Mailing Address - Zip Code:00602-9671
Mailing Address - Country:US
Mailing Address - Phone:787-691-2907
Mailing Address - Fax:
Practice Address - Street 1:203 KINGSWAY RD
Practice Address - Street 2:
Practice Address - City:BRANDON
Practice Address - State:FL
Practice Address - Zip Code:33510-4679
Practice Address - Country:US
Practice Address - Phone:813-819-7780
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-28
Last Update Date:2022-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR22716208D00000X
FLACN1450208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice