Provider Demographics
NPI:1285028589
Name:QUINTANA CABRERA, ELISBETH (PTA)
Entity Type:Individual
Prefix:
First Name:ELISBETH
Middle Name:
Last Name:QUINTANA CABRERA
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7741 NW 7TH ST
Mailing Address - Street 2:APT 619
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33126-6112
Mailing Address - Country:US
Mailing Address - Phone:786-863-5594
Mailing Address - Fax:
Practice Address - Street 1:7741 NW 7TH ST
Practice Address - Street 2:APT 619
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33126-6112
Practice Address - Country:US
Practice Address - Phone:786-863-5594
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-03-24
Last Update Date:2015-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPTA25540225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant