Healthcare Provider Details

I. General information

NPI: 1093312902
Provider Name (Legal Business Name): MARLEN CABRERA BCABA 0-26-17242
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/04/2020
Last Update Date: 06/15/2026
Certification Date: 06/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11040 SW 196TH ST APT 402
CUTLER BAY FL
33157-8492
US

IV. Provider business mailing address

11040 SW 196TH ST APT 402
CUTLER BAY FL
33157-8492
US

V. Phone/Fax

Practice location:
  • Phone: 786-344-8302
  • Fax:
Mailing address:
  • Phone: 786-344-8302
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106E00000X
TaxonomyAssistant Behavior Analyst
License Number0-26-17242
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: