Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207T00000X | Neurosurgeon | ME57563 | FL |
NPI | 1023109477 |
---|---|
Provider Name | Dr. Jose I Cabrera |
First Address | Port Charlotte, FL 33952-6619 |
Second Address | Port Charlotte, FL 33952-6619 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/09/2006 |
Last Update Date | 03/08/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000305000 | (05) | FL |
278507205 | (05) | FL |
C28739 | (02) | FL |