Basic Information
| Provider Information | |||||||||
| NPI: | 1831337930 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | CABRERA | ||||||||
| FirstName: | EDUARDO | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 15215 COLLIER BLVD STE 320 | ||||||||
| Address2: | |||||||||
| City: | NAPLES | ||||||||
| State: | FL | ||||||||
| PostalCode: | 341196836 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2393484221 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 15215 COLLIER BLVD STE 320 | ||||||||
| Address2: | |||||||||
| City: | NAPLES | ||||||||
| State: | FL | ||||||||
| PostalCode: | 341196836 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2393484221 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/27/2009 | ||||||||
| LastUpdateDate: | 09/10/2020 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 09/10/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 390200000X | 036.126363 | IL | N | Student, Health Care | Student in an Organized Health Care Education/Training Program | 207Q00000X | 036126363 | IL | N | Allopathic & Osteopathic Physicians | Family Medicine | 207Q00000X | 137375 | FL | Y | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.