Provider Demographics
NPI:1669015962
Name:BASCOY-CABRERA, LISBETH (APRN)
Entity type:Individual
Prefix:
First Name:LISBETH
Middle Name:
Last Name:BASCOY-CABRERA
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9601 SW 100TH AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33176-2833
Mailing Address - Country:US
Mailing Address - Phone:305-336-2404
Mailing Address - Fax:
Practice Address - Street 1:4200 SW 8TH ST
Practice Address - Street 2:
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33134-2619
Practice Address - Country:US
Practice Address - Phone:305-777-9604
Practice Address - Fax:305-777-9605
Is Sole Proprietor?:No
Enumeration Date:2019-10-21
Last Update Date:2019-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11003483363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily