Provider Demographics
NPI:1992136717
Name:CABRERA, ALLAN FRIVALDO (OTR/L)
Entity type:Individual
Prefix:
First Name:ALLAN
Middle Name:FRIVALDO
Last Name:CABRERA
Suffix:
Gender:M
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1580 SAWGRS CORP PKWY
Mailing Address - Street 2:100
Mailing Address - City:SUNRISE
Mailing Address - State:FL
Mailing Address - Zip Code:33323-2859
Mailing Address - Country:US
Mailing Address - Phone:954-332-4445
Mailing Address - Fax:
Practice Address - Street 1:1580 SAWGRS CORP PKWY
Practice Address - Street 2:100
Practice Address - City:SUNRISE
Practice Address - State:FL
Practice Address - Zip Code:33323-2859
Practice Address - Country:US
Practice Address - Phone:954-332-4445
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-12-04
Last Update Date:2022-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM3102225X00000X
NMOT4569225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist