Provider Demographics
NPI:1194511329
Name:FERNANDEZ CABALO, KIRSIA
Entity type:Individual
Prefix:
First Name:KIRSIA
Middle Name:
Last Name:FERNANDEZ CABALO
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10307 SW 24TH ST APT 205
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33165-7903
Mailing Address - Country:US
Mailing Address - Phone:786-813-9581
Mailing Address - Fax:
Practice Address - Street 1:10307 SW 24TH ST APT 205
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33165-7903
Practice Address - Country:US
Practice Address - Phone:786-813-9581
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-15
Last Update Date:2025-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL2024781374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide