Provider Demographics
NPI:1104795798
Name:CABRERA DURAN, LITZANDRA
Entity type:Individual
Prefix:
First Name:LITZANDRA
Middle Name:
Last Name:CABRERA DURAN
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 1:2586 FREEPORT RD
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33406-7707
Mailing Address - Country:US
Mailing Address - Phone:561-851-1526
Mailing Address - Fax:
Practice Address - Street 1:2586 FREEPORT RD
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33406-7707
Practice Address - Country:US
Practice Address - Phone:561-851-1526
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-11-01
Last Update Date:2025-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLC622304503000106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior TechnicianGroup - Single Specialty