Provider Demographics
NPI:1912026006
Name:CABRERA RICABAL, LAZARA (PHARMD)
Entity Type:Individual
Prefix:MISS
First Name:LAZARA
Middle Name:
Last Name:CABRERA RICABAL
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1901 BRICKELL AVE APT 1906
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33129-1724
Mailing Address - Country:US
Mailing Address - Phone:786-234-0484
Mailing Address - Fax:
Practice Address - Street 1:1625 CORDOVA RD
Practice Address - Street 2:
Practice Address - City:FT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33316-2132
Practice Address - Country:US
Practice Address - Phone:954-467-8555
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-28
Last Update Date:2015-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS41882183500000X
FLPU68061835G0303X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
No1835G0303XPharmacy Service ProvidersPharmacistGeriatric