Healthcare Provider Details

I. General information

NPI: 1144110107
Provider Name (Legal Business Name): GEOSVANIS CIFRAT CABRERA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

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

III. Provider practice location address

1550 NE 123RD ST APT 504
NORTH MIAMI FL
33161-6073
US

IV. Provider business mailing address

1550 NE 123RD ST APT 504
NORTH MIAMI FL
33161-6073
US

V. Phone/Fax

Practice location:
  • Phone: 786-714-0142
  • Fax:
Mailing address:
  • Phone: 786-714-0142
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: