Provider Demographics
NPI:1528564093
Name:CABRERA, INDIRA D
Entity Type:Individual
Prefix:MS
First Name:INDIRA
Middle Name:D
Last Name:CABRERA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:330 NW 114TH AVE APT 102
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33172
Mailing Address - Country:US
Mailing Address - Phone:305-639-0771
Mailing Address - Fax:
Practice Address - Street 1:330 NW 114TH AVE APT 102
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33172-4762
Practice Address - Country:US
Practice Address - Phone:305-639-0771
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-03
Last Update Date:2018-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior TechnicianGroup - Single Specialty