Healthcare Provider Details

I. General information

NPI: 1013336361
Provider Name (Legal Business Name): ALEJANDRO CABRERA PTA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/15/2014
Last Update Date: 04/15/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 S BISCAYNE BLVD STE 15A
MIAMI FL
33131-2368
US

IV. Provider business mailing address

200 S BISCAYNE BLVD STE 15A
MIAMI FL
33131-2368
US

V. Phone/Fax

Practice location:
  • Phone: 305-381-6223
  • Fax:
Mailing address:
  • Phone: 305-381-6223
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPTA24764
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: