Healthcare Provider Details

I. General information

NPI: 1104736438
Provider Name (Legal Business Name): KATYANA CABRERA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/09/2026
Last Update Date: 09/09/2026
Certification Date: 09/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1166 E BLUE HERON BLVD
RIVIERA BEACH FL
33404-4738
US

IV. Provider business mailing address

13746 40TH LN N
WEST PALM BEACH FL
33411-8403
US

V. Phone/Fax

Practice location:
  • Phone: 561-556-8980
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number693110
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: