Provider Demographics
NPI:1689409740
Name:CABRERA, YASMIN
Entity type:Individual
Prefix:
First Name:YASMIN
Middle Name:
Last Name:CABRERA
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:120 ROYAL PALM RD APT 110
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33016-4610
Mailing Address - Country:US
Mailing Address - Phone:786-669-0809
Mailing Address - Fax:
Practice Address - Street 1:120 ROYAL PALM RD APT 110
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33016-4610
Practice Address - Country:US
Practice Address - Phone:786-669-0809
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-06
Last Update Date:2025-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-24-375077106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL123925300Medicaid