MEDICARE: MONICA CABRERA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YA0400X	Addiction (Substance Use Disorder) Counselor
2	171M00000X	Case Manager/Care Coordinator

General Provider Information

NPI Number	:	1639629090
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MONICA CABRERA

Provider Business Mailing Address
First Line	:	450 NE 44TH ST
Second Line	:
City	:	OAKLAND PARK
State	:	FL
Zip	:	33334-1423
Country	:	US
Telephone Number	:	954-462-4599
Fax Number	:	954-530-9597

Provider Business Practice Location Address
First Line	:	450 NE 44TH ST
Second Line	:
City	:	OAKLAND PARK
State	:	FL
Zip	:	33334-1423
Country	:	US
Telephone Number	:	954-462-4599
Fax Number	:	954-530-9597

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/10/2016
Last Update Date	:	10/10/2016

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