Provider Demographics
NPI:1437930732
Name:CABRERA, KERRY (APRN)
Entity Type:Individual
Prefix:MS
First Name:KERRY
Middle Name:
Last Name:CABRERA
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4450 NW 113TH LN
Mailing Address - Street 2:
Mailing Address - City:CORAL SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33065-7212
Mailing Address - Country:US
Mailing Address - Phone:654-478-7225
Mailing Address - Fax:
Practice Address - Street 1:6279 W SAMPLE RD STE 305
Practice Address - Street 2:
Practice Address - City:CORAL SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33067-3175
Practice Address - Country:US
Practice Address - Phone:954-478-7225
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-12
Last Update Date:2023-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11029129207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine