Provider Demographics
NPI:1912614629
Name:CABRERA SAFONST, RAFAEL ALFREDO (CAP,ICADC)
Entity type:Individual
Prefix:MR
First Name:RAFAEL
Middle Name:ALFREDO
Last Name:CABRERA SAFONST
Suffix:
Gender:M
Credentials:CAP,ICADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2691 NE 2ND AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33137-4414
Mailing Address - Country:US
Mailing Address - Phone:305-576-6611
Mailing Address - Fax:855-346-9049
Practice Address - Street 1:2691 NE 2ND AVE
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33137-4414
Practice Address - Country:US
Practice Address - Phone:305-576-6611
Practice Address - Fax:855-346-9049
Is Sole Proprietor?:Yes
Enumeration Date:2022-11-02
Last Update Date:2022-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCAP.0100428101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)