Jorge L Cabrera Rosario, DMD

Individual provider Active NPI Dentist · Comerio, PR

NPI 1821079641 · NPPES record last updated Apr 24, 2013

Key facts

NPI
1821079641
Entity type
Individual (NPI type 1)
Primary specialty
Dentist 122300000X
License
2253 (PR)
Practice address
Carr 779 KM 6.5 Bo Paalmas
Comerio, PR 00782
Phone
(787) 875-0448
Fax
(787) 875-1808
NPI assigned
Nov 9, 2005
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Enrolled in PR
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20150810001699 PR Order and Referring Only - Oral Surgery
Practitioner - Oral Surgery
4183939879

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
2253PRMDPsychologist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 2253 PR Yes

Addresses

Primary practice location

Carr 779 KM 6.5 Bo Paalmas
Comerio, PR 00782

Mailing address

PMB 92 HC 71 Box 3766
Naranzito, PR 00719
Phone (787) 875-0448

Other providers in Comerio, PR

All providers in Comerio, PR · Dentist in Puerto Rico

Sources for this page

Verify at the official NPI Registry.