MEDICARE: TERESA CABRERA

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	251E00000X	Home Health Agency
2	103K00000X	Behavior Analyst

General Provider Information

NPI Number	:	1720438609
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TERESA CABRERA

Provider Business Mailing Address
First Line	:	6831 W 14TH CT APT 111
Second Line	:
City	:	HIALEAH
State	:	FL
Zip	:	33014-4530
Country	:	US
Telephone Number	:	954-394-2835
Fax Number	:

Provider Business Practice Location Address
First Line	:	6831 W 14TH CT APT 111
Second Line	:
City	:	HIALEAH
State	:	FL
Zip	:	33014-4530
Country	:	US
Telephone Number	:	954-394-2835
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	TERESA CABRERRA
Credential	:
Telephone Number	:	954-394-2835

Provider Enumeration Date	:	06/21/2016
Last Update Date	:	11/21/2016

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Practice Location Address:

6831 W 14TH CT APT 111
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33014-4530

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1477198562 — MR. CARLOS LOBRAYIAN ESPINOZA
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1952078909 — AMANDA C DIAZ
Practice Location Address:

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1700554094 — ADRIAN CASANELLAS
Practice Location Address:

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Directions to “TERESA CABRERA ” Practice Location

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