Provider Demographics
NPI:1528116373
Name:MOISES CABRERA D.D.S. P.A.
Entity type:Organization
Organization Name:MOISES CABRERA D.D.S. P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MOISES
Authorized Official - Middle Name:
Authorized Official - Last Name:CABRERA
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:305-819-6761
Mailing Address - Street 1:101 E 50TH PL
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33013-1446
Mailing Address - Country:US
Mailing Address - Phone:305-819-6761
Mailing Address - Fax:305-388-1745
Practice Address - Street 1:14609 SW 104TH ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33186-2905
Practice Address - Country:US
Practice Address - Phone:305-388-3725
Practice Address - Fax:305-388-1745
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN 151141223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty