Provider Demographics
NPI:1548796170
Name:CABRERA, RAFAEL RONALDO (PHARM D)
Entity Type:Individual
Prefix:DR
First Name:RAFAEL
Middle Name:RONALDO
Last Name:CABRERA
Suffix:
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14-20 CALLE 9
Mailing Address - Street 2:SANTA ROSA
Mailing Address - City:BAYAMON
Mailing Address - State:PR
Mailing Address - Zip Code:00959-6629
Mailing Address - Country:US
Mailing Address - Phone:562-688-4817
Mailing Address - Fax:
Practice Address - Street 1:14-20 CALLE 9
Practice Address - Street 2:SANTA ROSA
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00959-6629
Practice Address - Country:US
Practice Address - Phone:562-688-4817
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-05-02
Last Update Date:2020-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR6463183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist