Provider Demographics
NPI:1114591245
Name:RODRIGUEZ CABRERA, FELIPE
Entity Type:Individual
Prefix:
First Name:FELIPE
Middle Name:
Last Name:RODRIGUEZ CABRERA
Suffix:
Gender:M
Credentials:
Other - Prefix:MR
Other - First Name:FELIPE
Other - Middle Name:
Other - Last Name:RODRIGUEZ CABRERA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:CBHCMS
Mailing Address - Street 1:6917 W 27TH AVE
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33016-5481
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:22790 SW 112TH AVE
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33170-7602
Practice Address - Country:US
Practice Address - Phone:305-235-2626
Practice Address - Fax:305-235-6178
Is Sole Proprietor?:No
Enumeration Date:2021-05-13
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL107567000Medicaid