Provider Demographics
NPI:1285239996
Name:CABRERA, SAMUEL ALEJANDRO JR (PA-C)
Entity type:Individual
Prefix:
First Name:SAMUEL
Middle Name:ALEJANDRO
Last Name:CABRERA
Suffix:JR
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1/1 SFG(A)
Mailing Address - Street 2:
Mailing Address - City:APO
Mailing Address - State:AP
Mailing Address - Zip Code:96376
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1ST BATTALION, 1ST SPECIAL FORCES GROUP
Practice Address - Street 2:BATTALION MEDICAL READINESS CLINIC, BLDG 103
Practice Address - City:APO
Practice Address - State:AP
Practice Address - Zip Code:96376
Practice Address - Country:US
Practice Address - Phone:315-652-5371
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-01
Last Update Date:2023-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant