Provider Demographics
NPI:1659347656
Name:CABRAL, RICHARD A (CRNA)
Entity type:Individual
Prefix:MR
First Name:RICHARD
Middle Name:A
Last Name:CABRAL
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:444 QUAKER LN
Mailing Address - Street 2:
Mailing Address - City:WARWICK
Mailing Address - State:RI
Mailing Address - Zip Code:02886-0185
Mailing Address - Country:US
Mailing Address - Phone:401-384-6537
Mailing Address - Fax:
Practice Address - Street 1:444 QUAKER LN
Practice Address - Street 2:
Practice Address - City:WARWICK
Practice Address - State:RI
Practice Address - Zip Code:02886-0185
Practice Address - Country:US
Practice Address - Phone:401-384-6537
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-02-28
Last Update Date:2024-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIAPRN00968367500000X
FLARNP2854442367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL304743100Medicaid
FLE7647XMedicare ID - Type Unspecified# FOR ANESCO ANEST. ASSOC
FLE7647YMedicare ID - Type Unspecified# FOR ANESCO CENTRAL LLC