Provider Demographics
NPI:1740796200
Name:CABRERA, VANESSA BLANCO (ARNP)
Entity Type:Individual
Prefix:
First Name:VANESSA
Middle Name:BLANCO
Last Name:CABRERA
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5481 SW 60TH ST
Mailing Address - Street 2:UNIT 301
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34474-5653
Mailing Address - Country:US
Mailing Address - Phone:352-504-0092
Mailing Address - Fax:352-504-0162
Practice Address - Street 1:5481 SW 60TH ST
Practice Address - Street 2:UNIT 301
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34474-5653
Practice Address - Country:US
Practice Address - Phone:352-504-0092
Practice Address - Fax:352-504-0162
Is Sole Proprietor?:Yes
Enumeration Date:2017-12-20
Last Update Date:2023-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN9375107363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
MW5783318OtherDEA REGISTRATION NUMBER