Provider Demographics
NPI:1972709012
Name:FERNANDEZ CABRERA, JOSEPH (MD)
Entity type:Individual
Prefix:
First Name:JOSEPH
Middle Name:
Last Name:FERNANDEZ CABRERA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 12336
Mailing Address - Street 2:PEDIATRICS AND SPORTS MEDICINE PCS
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00914-0336
Mailing Address - Country:US
Mailing Address - Phone:732-255-3877
Mailing Address - Fax:732-255-3885
Practice Address - Street 1:ATHLETIC TRAINING
Practice Address - Street 2:URB SANTA JUANITA, CALLE QUINTANA BH9
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00956
Practice Address - Country:US
Practice Address - Phone:939-264-1889
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-25
Last Update Date:2020-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR185232080S0010X, 208000000X, 2083S0010X
NJ25MA087766002083S0010X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083S0010XAllopathic & Osteopathic PhysiciansPreventive MedicineSports Medicine
No2080S0010XAllopathic & Osteopathic PhysiciansPediatricsSports Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics