Provider Demographics
NPI:1063982528
Name:CABRERA, STEPHANIE MARTHA (APRN)
Entity type:Individual
Prefix:MRS
First Name:STEPHANIE
Middle Name:MARTHA
Last Name:CABRERA
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:16969 NW 67TH AVE STE 205
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33015-4294
Mailing Address - Country:US
Mailing Address - Phone:786-860-8844
Mailing Address - Fax:786-892-9876
Practice Address - Street 1:16969 NW 67TH AVE STE 205
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33015-4294
Practice Address - Country:US
Practice Address - Phone:786-860-8844
Practice Address - Fax:786-892-9876
Is Sole Proprietor?:Yes
Enumeration Date:2018-11-27
Last Update Date:2024-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11001673363LF0000X, 363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty