Healthcare Provider Details

I. General information

NPI: 1427466390
Provider Name (Legal Business Name): ODALYS CABRERA-PEREIRA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/23/2014
Last Update Date: 08/04/2020
Certification Date: 08/04/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

336 NW 5TH ST
MIAMI FL
33128-1616
US

IV. Provider business mailing address

3191 W 77TH PL
HIALEAH FL
33018-3856
US

V. Phone/Fax

Practice location:
  • Phone: 305-577-4840
  • Fax:
Mailing address:
  • Phone: 866-821-7437
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License NumberARNP9305610
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAPRN9305610
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: