Provider Demographics
NPI:1306971361
Name:JUAIRE CABRAL, ALICIA MARIA (MSPT)
Entity type:Individual
Prefix:
First Name:ALICIA
Middle Name:MARIA
Last Name:JUAIRE CABRAL
Suffix:
Gender:F
Credentials:MSPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:381 SOUTH AVE
Mailing Address - Street 2:
Mailing Address - City:ATTLEBORO
Mailing Address - State:MA
Mailing Address - Zip Code:02703-3343
Mailing Address - Country:US
Mailing Address - Phone:508-685-9899
Mailing Address - Fax:
Practice Address - Street 1:150 PARKINGWAY
Practice Address - Street 2:
Practice Address - City:QUINCY
Practice Address - State:MA
Practice Address - Zip Code:02169-5058
Practice Address - Country:US
Practice Address - Phone:617-770-2224
Practice Address - Fax:617-847-6935
Is Sole Proprietor?:No
Enumeration Date:2007-02-22
Last Update Date:2019-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA17826225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0000115Medicare PIN