Provider Demographics
NPI:1730953811
Name:CABASSA CABAN, SVEN JOEL
Entity type:Individual
Prefix:
First Name:SVEN
Middle Name:JOEL
Last Name:CABASSA CABAN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1395
Mailing Address - Street 2:
Mailing Address - City:HORMIGUEROS
Mailing Address - State:PR
Mailing Address - Zip Code:00660
Mailing Address - Country:US
Mailing Address - Phone:787-373-3249
Mailing Address - Fax:
Practice Address - Street 1:CALLE 20 PARCELA ELIZABETH III #646
Practice Address - Street 2:
Practice Address - City:CABO ROJO
Practice Address - State:PR
Practice Address - Zip Code:00623
Practice Address - Country:US
Practice Address - Phone:787-373-3249
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-09
Last Update Date:2024-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR97796163WG0600X, 163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health
No163WG0600XNursing Service ProvidersRegistered NurseGerontology