Healthcare Provider Details

I. General information

NPI: 1003320987
Provider Name (Legal Business Name): BRITTANY ANN CABRERA LMT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/29/2017
Last Update Date: 03/17/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

910 MOUNT HOMER RD
EUSTIS FL
32726-6258
US

IV. Provider business mailing address

13312 GEORGIA AVE
ASTATULA FL
34705-9449
US

V. Phone/Fax

Practice location:
  • Phone: 352-357-8615
  • Fax:
Mailing address:
  • Phone: 786-389-3479
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: