Provider Demographics
NPI:1295738607
Name:CABEZUDO, VICTOR (ARNP)
Entity type:Individual
Prefix:
First Name:VICTOR
Middle Name:
Last Name:CABEZUDO
Suffix:
Gender:M
Credentials:ARNP
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 540233
Mailing Address - Street 2:
Mailing Address - City:LAKE WORTH
Mailing Address - State:FL
Mailing Address - Zip Code:33454-0233
Mailing Address - Country:US
Mailing Address - Phone:561-635-8855
Mailing Address - Fax:561-635-8855
Practice Address - Street 1:19065 FLY ROD RUN
Practice Address - Street 2:
Practice Address - City:LOXAHATCHEE
Practice Address - State:FL
Practice Address - Zip Code:33470-6024
Practice Address - Country:US
Practice Address - Phone:561-635-8855
Practice Address - Fax:561-635-8855
Is Sole Proprietor?:Yes
Enumeration Date:2005-05-31
Last Update Date:2025-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP3162712363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLP66324Medicare UPIN