Provider Demographics
NPI:1659159614
Name:AGUIAR CABRERA, GABRIEL LIUSVIL SR
Entity Type:Individual
Prefix:MR
First Name:GABRIEL
Middle Name:LIUSVIL
Last Name:AGUIAR CABRERA
Suffix:SR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5592 MORINO WAY
Mailing Address - Street 2:
Mailing Address - City:AVE MARIA
Mailing Address - State:FL
Mailing Address - Zip Code:34142-5111
Mailing Address - Country:US
Mailing Address - Phone:123-929-8414
Mailing Address - Fax:
Practice Address - Street 1:5592 MORINO WAY
Practice Address - Street 2:
Practice Address - City:AVE MARIA
Practice Address - State:FL
Practice Address - Zip Code:34142-5111
Practice Address - Country:US
Practice Address - Phone:239-298-4145
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-20
Last Update Date:2023-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician