Provider Demographics
NPI:1952323107
Name:CABRERA, NESTOR ANTONIO (MD)
Entity Type:Individual
Prefix:DR
First Name:NESTOR
Middle Name:ANTONIO
Last Name:CABRERA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:NESTOR
Other - Middle Name:ANTONIO
Other - Last Name:CABRERA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:J6 MANSIONES REALES
Mailing Address - Street 2:
Mailing Address - City:GUAYNABO
Mailing Address - State:PR
Mailing Address - Zip Code:00969-4810
Mailing Address - Country:US
Mailing Address - Phone:787-463-8110
Mailing Address - Fax:
Practice Address - Street 1:10 CALLE CASIA
Practice Address - Street 2:SAN JUAN MED CTR
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00921
Practice Address - Country:US
Practice Address - Phone:787-758-9662
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-24
Last Update Date:2017-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR8264207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR8264OtherSTATE LICENSE
PR80187Medicare ID - Type Unspecified
PRE09031Medicare UPIN