MEDICARE: LIENA CABRERA BLANCO BACB

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106S00000X	Behavior Technician	RBT-25-431445	FL

General Provider Information

NPI Number	:	1518758382
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LIENA CABRERA BLANCO BACB

Provider Business Mailing Address
First Line	:	14361 MADISON ST
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33176-7337
Country	:	US
Telephone Number	:	201-306-2842
Fax Number	:

Provider Business Practice Location Address
First Line	:	306 ALCAZAR AVE STE 200
Second Line	:
City	:	CORAL GABLES
State	:	FL
Zip	:	33134-4318
Country	:	US
Telephone Number	:	305-967-8725
Fax Number	:	305-967-8446

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/13/2025
Last Update Date	:	05/13/2025

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