Healthcare Provider Details

I. General information

NPI: 1699692681
Provider Name (Legal Business Name): MICHEL BORDON CABRERA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/01/2026
Last Update Date: 07/01/2026
Certification Date: 07/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17602 SW 36TH AVENUE RD
OCALA FL
34473-4284
US

IV. Provider business mailing address

17602 SW 36TH AVENUE RD
OCALA FL
34473-4284
US

V. Phone/Fax

Practice location:
  • Phone: 561-983-7102
  • Fax:
Mailing address:
  • Phone: 561-983-7102
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: