Provider Demographics
NPI:1205894516
Name:CABRERA-BEAUCHAMP, CARMEN MAGALI (MD)
Entity type:Individual
Prefix:MRS
First Name:CARMEN
Middle Name:MAGALI
Last Name:CABRERA-BEAUCHAMP
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:PO BOX 2209
Mailing Address - Street 2:
Mailing Address - City:GUAYNABO
Mailing Address - State:PR
Mailing Address - Zip Code:00970-2209
Mailing Address - Country:US
Mailing Address - Phone:787-787-8210
Mailing Address - Fax:787-785-8589
Practice Address - Street 1:BAYAMON MEDICAL PLAZA
Practice Address - Street 2:SUITE 711 CARR 2 KM 11-7
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00959
Practice Address - Country:US
Practice Address - Phone:787-787-8210
Practice Address - Fax:787-785-8589
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-03
Last Update Date:2014-02-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PR8729208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
D34202Medicare UPIN
PR0029814Medicare PIN