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General NPI Number Information
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NPI Number | 1790505667
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Entity Type | Individual
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Provider Name | JORGE CABRERA
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Gender | Male
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Dates
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Enumeration Date | 10/15/2024
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Last Update Date | 10/15/2024
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Provider Practice Location Address
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Address Line | 12025 SW 186TH ST
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City | MIAMI
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State | FL
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Zip | 33177-3228
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Country | US
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Telephone | 786-454-0520
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Fax | 786-452-1200
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Provider Business Mailing Address
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Address Line | 15924 SW 92ND AVE
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City | MIAMI
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State | FL
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Zip | 33157-1842
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Country | US
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Telephone | 305-964-5824
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Fax | 786-452-1200
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | CBHCM.0105363
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License Number State | FL
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