Provider Demographics
NPI:1215452644
Name:CABRERA, LUZ GABRIELA (BCBA)
Entity type:Individual
Prefix:
First Name:LUZ
Middle Name:GABRIELA
Last Name:CABRERA
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9265 LAKE FISCHER BLVD
Mailing Address - Street 2:
Mailing Address - City:GOTHA
Mailing Address - State:FL
Mailing Address - Zip Code:34734-5204
Mailing Address - Country:US
Mailing Address - Phone:407-748-2825
Mailing Address - Fax:407-386-7133
Practice Address - Street 1:1181 W AIRPORT BLVD UNIT B
Practice Address - Street 2:
Practice Address - City:SANFORD
Practice Address - State:FL
Practice Address - Zip Code:32773-4972
Practice Address - Country:US
Practice Address - Phone:407-203-9698
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-08-07
Last Update Date:2024-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1-21-48480103K00000X
FLRBT-16-12937106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician