Provider Demographics
NPI:1437376639
Name:CABRERA DE ALONSO, ROXANA (DMD)
Entity Type:Individual
Prefix:
First Name:ROXANA
Middle Name:
Last Name:CABRERA DE ALONSO
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8726 NW 26TH ST STE 10
Mailing Address - Street 2:
Mailing Address - City:DORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33172-1628
Mailing Address - Country:US
Mailing Address - Phone:305-591-8044
Mailing Address - Fax:305-591-7533
Practice Address - Street 1:8726 NW 26TH ST STE 10
Practice Address - Street 2:
Practice Address - City:DORAL
Practice Address - State:FL
Practice Address - Zip Code:33172-1628
Practice Address - Country:US
Practice Address - Phone:305-591-8044
Practice Address - Fax:305-591-7533
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN130421223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice