Provider Demographics
NPI:1649254392
Name:CABRAL HIDALGO, ANGELA A (MD)
Entity type:Individual
Prefix:DR
First Name:ANGELA
Middle Name:A
Last Name:CABRAL HIDALGO
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:PMB 540 PO BOX 4960
Mailing Address - Street 2:
Mailing Address - City:CAGUAS
Mailing Address - State:PR
Mailing Address - Zip Code:00726-4960
Mailing Address - Country:US
Mailing Address - Phone:787-448-6165
Mailing Address - Fax:787-745-0108
Practice Address - Street 1:CALLE MUNOZ RIVERA #2
Practice Address - Street 2:
Practice Address - City:CAGUAS
Practice Address - State:PR
Practice Address - Zip Code:00725
Practice Address - Country:PK
Practice Address - Phone:787-286-2800
Practice Address - Fax:787-745-0108
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-05
Last Update Date:2010-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR14478208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR21330OtherTRIPLE S
PR0021330Medicare ID - Type Unspecified
PRH80168Medicare UPIN