Provider Demographics
NPI:1093907560
Name:CABIAC, ANNETTE RENEE (MD)
Entity Type:Individual
Prefix:DR
First Name:ANNETTE
Middle Name:RENEE
Last Name:CABIAC
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9964 UNIVERSITY BLVD
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32817-1802
Mailing Address - Country:US
Mailing Address - Phone:407-261-2956
Mailing Address - Fax:321-203-4655
Practice Address - Street 1:9964 UNIVERSITY BLVD
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32817-1802
Practice Address - Country:US
Practice Address - Phone:407-261-2956
Practice Address - Fax:321-203-4655
Is Sole Proprietor?:No
Enumeration Date:2007-08-17
Last Update Date:2020-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME105254208000000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLP01019254OtherMEDICARE RAILROAD PROVIDER NUMBER
FL001373300Medicaid
FLP01019254OtherMEDICARE RAILROAD PROVIDER NUMBER