Provider Demographics
NPI:1255301164
Name:CABRERA-BONET, PEDRO O (MD)
Entity Type:Individual
Prefix:
First Name:PEDRO
Middle Name:O
Last Name:CABRERA-BONET
Suffix:
Gender:M
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:PO BOX 6213
Mailing Address - Street 2:
Mailing Address - City:MAYAGUEZ
Mailing Address - State:PR
Mailing Address - Zip Code:00681-6213
Mailing Address - Country:US
Mailing Address - Phone:787-925-7246
Mailing Address - Fax:888-671-8400
Practice Address - Street 1:CENTERPLEX CARR 2 KM 133.5
Practice Address - Street 2:SUITE 304
Practice Address - City:AGUADA
Practice Address - State:PR
Practice Address - Zip Code:00602
Practice Address - Country:US
Practice Address - Phone:787-925-7246
Practice Address - Fax:888-671-8400
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-24
Last Update Date:2020-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA06787000207L00000X
PR018019207LC0200X
PR18019207LP2900X
NJ25MA067870208VP0014X
PR01819208VP0014X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain Medicine
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
No207LC0200XAllopathic & Osteopathic PhysiciansAnesthesiologyCritical Care Medicine
No207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR038603700Medicaid
NJ7842201Medicaid
PR18019OtherMEDICAL LICENSE
NJG79172Medicare UPIN
PR18019OtherMEDICAL LICENSE