Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0700X | Prosthodontist | DN13883 | FL |
NPI | 1023263621 |
---|---|
Provider Name | Dr. Juan J Cabanillas |
First Address | Fort Lauderdale, FL 33306-1664 |
Second Address | Delray Beach, FL 33445-3902 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 24/11/2008 |
Last Update Date | 28/07/2017 |