Provider Demographics
NPI:1013993435
Name:CABREROS, FLORA LORNA (MD)
Entity Type:Individual
Prefix:
First Name:FLORA LORNA
Middle Name:
Last Name:CABREROS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5992 BERRYHILL RD
Mailing Address - Street 2:SUITE 303
Mailing Address - City:MILTON
Mailing Address - State:FL
Mailing Address - Zip Code:32570-1013
Mailing Address - Country:US
Mailing Address - Phone:850-626-4208
Mailing Address - Fax:850-626-4211
Practice Address - Street 1:5992 BERRYHILL RD
Practice Address - Street 2:SUITE 303
Practice Address - City:MILTON
Practice Address - State:FL
Practice Address - Zip Code:32570
Practice Address - Country:US
Practice Address - Phone:850-626-4208
Practice Address - Fax:850-626-4211
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-17
Last Update Date:2018-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME86003207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL265917400Medicaid
FLH76474Medicare UPIN
FL265917400Medicaid