Provider Demographics
NPI:1497849673
Name:CABRERA GARCIA, ANIANO N (MD)
Entity Type:Individual
Prefix:
First Name:ANIANO
Middle Name:N
Last Name:CABRERA GARCIA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1401 SW 1ST ST
Mailing Address - Street 2:SUITE 101
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33135-2261
Mailing Address - Country:US
Mailing Address - Phone:305-649-1100
Mailing Address - Fax:305-649-2060
Practice Address - Street 1:1401 SW 1ST ST
Practice Address - Street 2:SUITE 101
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33135-2261
Practice Address - Country:US
Practice Address - Phone:305-649-1100
Practice Address - Fax:305-649-2060
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-03
Last Update Date:2013-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME66410207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL376113400Medicaid
FL376113400Medicaid