Provider Demographics
NPI:1285422667
Name:RODRIGUEZ CABRERA, JESUS JAVIER
Entity type:Individual
Prefix:
First Name:JESUS
Middle Name:JAVIER
Last Name:RODRIGUEZ CABRERA
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15308 E POND WOODS DR
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33618-1832
Mailing Address - Country:US
Mailing Address - Phone:813-485-2976
Mailing Address - Fax:
Practice Address - Street 1:15308 E POND WOODS DR
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33618-1832
Practice Address - Country:US
Practice Address - Phone:813-485-2976
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-28
Last Update Date:2025-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL25-242246ZC0007X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Assistant