Provider Demographics
NPI:1184194094
Name:CABRERA GONZALEZ, YARI (RBT)
Entity Type:Individual
Prefix:
First Name:YARI
Middle Name:
Last Name:CABRERA GONZALEZ
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8009 W 6TH AVE APT N
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33014-4105
Mailing Address - Country:US
Mailing Address - Phone:786-230-5247
Mailing Address - Fax:
Practice Address - Street 1:8009 W 6TH AVE APT N
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33014-4105
Practice Address - Country:US
Practice Address - Phone:786-230-5247
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-12-04
Last Update Date:2021-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL106S00000X
FLRBT-18-58260106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL020469400Medicaid