Individual
DR. ALBERTO M CABANTOG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
240 W 11TH ST STE 103, ERIE, PA 16501-1758
(814) 790-5111
Mailing address
308 S HARBOR CITY BLVD, SUITE A, MELBOURNE, FL 32901-1500
(321) 733-0064
(321) 733-7970
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
ME96042
FL
208VP0014X
Interventional Pain Medicine Physician
Primary
MD458018
PA
208VP0014X
Interventional Pain Medicine Physician
ME 96402
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
202705274
GREAT WEST
MA
01
—
202705274004
TRICARE
MA
05
—
2036525
—
MA
01
—
611000600
DOL
MA
01
—
7245558
AETNA
MA
01
—
97130902
NETWORK HEALTH
MA
01
—
AA58878
HPHC
MA
01
—
MD458018
STATE LICENSE
PA
Enumeration date
10/27/2005
Last updated
11/03/2023
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