| Doctor Name: | DR. LEOVIGILDO CABRERA GANGOY |
| NPI Number: | 1184685554 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | M.D. |
| License Number: | 0000021597 |
| Business Practice Address: | 620 John Paul Jones Cir Portsmouth, VA - 237082111 |
| Business Phone Number: | 7579535000 |
| Business Fax Number: | |
| Mailing Address: | 5156 Crystal Point Dr, VIRGINIA BEACH |
| State: | VA |
| Postal Code: | 234553965 |
| Phone Number: | 7579538745 |
| Fax Number: | |
| NPI Enumeration Date: | 03/28/2006 |
| NPI Last Update Date: | 02/08/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | 0000021597 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | TN |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |