Provider Demographics
NPI:1659347656
Name:CABRAL, RICHARD A (CRNA)
Entity Type:Individual
Prefix:MR
First Name:RICHARD
Middle Name:A
Last Name:CABRAL
Suffix:
Gender:M
Credentials:CRNA
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Mailing Address - Street 1:3601 W COMMERCIAL BLVD
Mailing Address - Street 2:CO ANESCO NROTH BROWARD LLC 45
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33309-3300
Mailing Address - Country:US
Mailing Address - Phone:954-485-5666
Mailing Address - Fax:954-485-1651
Practice Address - Street 1:1600 S ANDREWS AVE
Practice Address - Street 2:C/O BROWARD GENERAL MEDICAL CENTER
Practice Address - City:FORT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33316-2510
Practice Address - Country:US
Practice Address - Phone:954-355-4400
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-28
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLARNP2854442367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLE7647ZMedicare ID - Type Unspecified
FLE7647XMedicare ID - Type Unspecified# FOR ANESCO ANEST. ASSOC
FLE7647YMedicare ID - Type Unspecified# FOR ANESCO CENTRAL LLC