Provider Demographics
NPI:1942515093
Name:CABRERA, LEISHA M (OT)
Entity Type:Individual
Prefix:
First Name:LEISHA
Middle Name:M
Last Name:CABRERA
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1380 N KROME AVE
Mailing Address - Street 2:SUITE 110
Mailing Address - City:FLORIDA CITY
Mailing Address - State:FL
Mailing Address - Zip Code:33034-2406
Mailing Address - Country:US
Mailing Address - Phone:305-247-4464
Mailing Address - Fax:305-247-4546
Practice Address - Street 1:1380 N KROME AVE
Practice Address - Street 2:SUITE 110
Practice Address - City:FLORIDA CITY
Practice Address - State:FL
Practice Address - Zip Code:33034-2406
Practice Address - Country:US
Practice Address - Phone:305-247-4464
Practice Address - Fax:305-247-4546
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-13
Last Update Date:2010-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOT13661225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLOT13661OtherFLORIDA DEPARTMENT OF HEALTH LICENCE