1720512031 NPI number — MR. LUIS DAVID FIGUEROA CABRERA MD

Table of content: MR. LUIS DAVID FIGUEROA CABRERA MD (NPI 1720512031)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1720512031 NPI number — MR. LUIS DAVID FIGUEROA CABRERA MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
FIGUEROA CABRERA
Provider First Name:
LUIS
Provider Middle Name:
DAVID
Provider Name Prefix Text:
MR.
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
FIGUEROA CABRERA
Provider Other First Name:
LUIS
Provider Other Middle Name:
DAVID
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
MD
Provider Other Last Name Type Code:
5

NPI Number Information

NPI Number:
1720512031
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/19/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
20900 BISCAYNE BLVD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
AVENTURA
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33180-1495
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
305-682-7000
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
20900 BISCAYNE BLVD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
AVENTURA
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33180-1407
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
305-682-7000
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
04/13/2017

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 390200000X , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207R00000X , with the licence number: ME147504 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 110731200 . This is a "Florida Medicaid Provider ID" identifier , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".