Provider Demographics
NPI:1902912454
Name:CABRERA, LUIS RENE (MD)
Entity type:Individual
Prefix:
First Name:LUIS
Middle Name:RENE
Last Name:CABRERA
Suffix:
Gender:M
Credentials:MD
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Other - Credentials:
Mailing Address - Street 1:6101 BLUE LAGOON DR STE 400
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33126-2051
Mailing Address - Country:US
Mailing Address - Phone:305-505-5530
Mailing Address - Fax:305-675-2478
Practice Address - Street 1:1648 NE 163RD ST
Practice Address - Street 2:
Practice Address - City:NORTH MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33162-4731
Practice Address - Country:US
Practice Address - Phone:305-949-2000
Practice Address - Fax:305-957-1166
Is Sole Proprietor?:No
Enumeration Date:2006-08-21
Last Update Date:2021-12-05
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Provider Licenses
StateLicense IDTaxonomies
FLME87357207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL013954800Medicaid