Provider Demographics
NPI:1346682325
Name:JOVEL-CABRERA, RUDDY ALEXANDER (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:RUDDY
Middle Name:ALEXANDER
Last Name:JOVEL-CABRERA
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:DR
Other - First Name:RUDDY
Other - Middle Name:ALEXANDER
Other - Last Name:JOVEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARMD
Mailing Address - Street 1:2901 EUCLID AVE APT 619
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44115-2422
Mailing Address - Country:US
Mailing Address - Phone:760-498-7921
Mailing Address - Fax:
Practice Address - Street 1:20405 CHAGRIN BLVD
Practice Address - Street 2:
Practice Address - City:SHAKER HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44122-5324
Practice Address - Country:US
Practice Address - Phone:216-752-4866
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-07-19
Last Update Date:2013-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03233019183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist