Provider Demographics
NPI:1720438609
Name:TERESA CABRERA
Entity Type:Organization
Organization Name:TERESA CABRERA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TERESA
Authorized Official - Middle Name:
Authorized Official - Last Name:CABRERRA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-394-2835
Mailing Address - Street 1:6831 W 14TH CT APT 111
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33014-4530
Mailing Address - Country:US
Mailing Address - Phone:954-394-2835
Mailing Address - Fax:
Practice Address - Street 1:6831 W 14TH CT APT 111
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33014-4530
Practice Address - Country:US
Practice Address - Phone:954-394-2835
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-06-21
Last Update Date:2016-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty
No251E00000XAgenciesHome HealthGroup - Single Specialty