Provider Demographics
NPI:1700860566
Name:MORETTA CABRERA, SONNY H
Entity Type:Individual
Prefix:DR
First Name:SONNY
Middle Name:H
Last Name:MORETTA CABRERA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:ED MEDICO PROF. 211
Mailing Address - Street 2:AVE. LOS CORAZONES 1065
Mailing Address - City:MAYAGUEZ
Mailing Address - State:PR
Mailing Address - Zip Code:00680
Mailing Address - Country:US
Mailing Address - Phone:787-833-9376
Mailing Address - Fax:
Practice Address - Street 1:ED MEDICO PROF. 211
Practice Address - Street 2:AVE. LOS CORAZONES 1065
Practice Address - City:MAYAGUEZ
Practice Address - State:PR
Practice Address - Zip Code:00680
Practice Address - Country:US
Practice Address - Phone:787-833-9376
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-05
Last Update Date:2013-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR53472086S0105X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0105XAllopathic & Osteopathic PhysiciansSurgerySurgery of the Hand
Provider Identifiers
StateIdentifier IDID TypeIssuer
PRC79619Medicare UPIN