Provider Demographics
NPI:1285827352
Name:CABELLO GROUPO SERVICIO CORP
Entity Type:Organization
Organization Name:CABELLO GROUPO SERVICIO CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:MIGUEL
Authorized Official - Middle Name:
Authorized Official - Last Name:CABELLO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-433-4051
Mailing Address - Street 1:1032 S MILITARY TRL
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33415-4717
Mailing Address - Country:US
Mailing Address - Phone:561-433-4051
Mailing Address - Fax:561-433-4052
Practice Address - Street 1:1032 S MILITARY TRL
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33415-4717
Practice Address - Country:US
Practice Address - Phone:561-433-4051
Practice Address - Fax:561-433-4052
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-22
Last Update Date:2007-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLHCC7203261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy