Healthcare Provider Details

I. General information

NPI: 1518896877
Provider Name (Legal Business Name): GIANCARLO CABRERA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/14/2026
Last Update Date: 05/14/2026
Certification Date: 05/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13155 SW 134TH ST
MIAMI FL
33186-4486
US

IV. Provider business mailing address

15619 SW 15TH TER
MIAMI FL
33194-2630
US

V. Phone/Fax

Practice location:
  • Phone: 786-842-3624
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106E00000X
TaxonomyAssistant Behavior Analyst
License NumberRBT-26-522911
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: