Healthcare Provider Details

I. General information

NPI: 1013415785
Provider Name (Legal Business Name): RICARDO NESTOR CABRERA NUNEZ P.A.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/29/2018
Last Update Date: 06/13/2026
Certification Date: 06/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8930 SW 25TH ST
MIAMI FL
33165-2021
US

IV. Provider business mailing address

8930 SW 25TH ST
MIAMI FL
33165-2021
US

V. Phone/Fax

Practice location:
  • Phone: 305-300-0180
  • Fax:
Mailing address:
  • Phone: 305-300-0180
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number3135-P.A.
License Number StatePR
# 2
Primary TaxonomyN
Taxonomy Code363AS0400X
TaxonomySurgical Physician Assistant
License Number3135-P.A.
License Number StatePR
# 3
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberTLHT1503
License Number StateFL
# 4
Primary TaxonomyN
Taxonomy Code246ZC0007X
TaxonomySurgical Assistant
License Number25-328
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: