Healthcare Provider Details

I. General information

NPI: 1699665703
Provider Name (Legal Business Name): MARIA FERNANDA CABRERA GALAN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/09/2025
Last Update Date: 06/10/2026
Certification Date: 06/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2075 W 76TH ST UNIT 1
HIALEAH FL
33016-1834
US

IV. Provider business mailing address

10342 SW 164TH CT
MIAMI FL
33196-1093
US

V. Phone/Fax

Practice location:
  • Phone: 786-391-4030
  • Fax:
Mailing address:
  • Phone: 786-226-5578
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberRBT-25-440833
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: