Provider Demographics
NPI:1962004408
Name:MARTIN CABRERA DA SILVA, ALEXANDRE JAIR
Entity Type:Individual
Prefix:MR
First Name:ALEXANDRE
Middle Name:JAIR
Last Name:MARTIN CABRERA DA SILVA
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 1:5400 NW 39TH AVE APT 14
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32606-6962
Mailing Address - Country:US
Mailing Address - Phone:352-872-1701
Mailing Address - Fax:
Practice Address - Street 1:1395 CENTER DR RM D9-6
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32610-3006
Practice Address - Country:US
Practice Address - Phone:352-273-5850
Practice Address - Fax:352-846-1643
Is Sole Proprietor?:No
Enumeration Date:2020-11-10
Last Update Date:2020-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL772122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist