Provider Demographics
NPI:1104114958
Name:CABRERA, KARELY (MD)
Entity type:Individual
Prefix:
First Name:KARELY
Middle Name:
Last Name:CABRERA
Suffix:
Gender:F
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 417
Mailing Address - Street 2:
Mailing Address - City:STUART
Mailing Address - State:FL
Mailing Address - Zip Code:34995-0417
Mailing Address - Country:US
Mailing Address - Phone:772-232-2832
Mailing Address - Fax:772-781-2792
Practice Address - Street 1:3066 SW MARTIN DOWNS BLVD
Practice Address - Street 2:
Practice Address - City:PALM CITY
Practice Address - State:FL
Practice Address - Zip Code:34990-2683
Practice Address - Country:US
Practice Address - Phone:772-781-2791
Practice Address - Fax:772-781-2792
Is Sole Proprietor?:No
Enumeration Date:2011-07-14
Last Update Date:2021-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA76479207RI0200X
FLME133060207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL023105200Medicaid