Provider Demographics
NPI:1750485918
Name:CABRAL DE BEAUCHAMP, MIGUELINA (MD)
Entity Type:Individual
Prefix:DR
First Name:MIGUELINA
Middle Name:
Last Name:CABRAL DE BEAUCHAMP
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 11950
Mailing Address - Street 2:CAPARRA HEIGHTS STATION
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00922-1950
Mailing Address - Country:US
Mailing Address - Phone:787-743-0676
Mailing Address - Fax:787-760-3651
Practice Address - Street 1:HIMA PLAZA I SUITE 308
Practice Address - Street 2:LUIS MUNOZ MARIN AVE #100 DEGETAU AVE
Practice Address - City:CAGUAS
Practice Address - State:PR
Practice Address - Zip Code:00725
Practice Address - Country:US
Practice Address - Phone:787-743-0676
Practice Address - Fax:787-760-3651
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-11
Last Update Date:2013-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR10229207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR82559Medicare ID - Type UnspecifiedPROVIDER NUMBER
PRF00956Medicare UPIN