Provider Demographics
NPI:1306491766
Name:CABRERA, ISABEL
Entity type:Individual
Prefix:
First Name:ISABEL
Middle Name:
Last Name:CABRERA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17840 SW 143RD CT
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33177-7661
Mailing Address - Country:US
Mailing Address - Phone:786-519-8745
Mailing Address - Fax:
Practice Address - Street 1:12700 SW 122ND AVE STE 110
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33186-5271
Practice Address - Country:US
Practice Address - Phone:786-353-2900
Practice Address - Fax:786-364-1676
Is Sole Proprietor?:Yes
Enumeration Date:2019-08-02
Last Update Date:2022-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1-20-46009103K00000X
FLRBT-18-62866106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLRBT-18-62866Medicaid