Provider Demographics
NPI:1689474264
Name:CABRERA, ANGEL JAVIER (FNP)
Entity type:Individual
Prefix:
First Name:ANGEL
Middle Name:JAVIER
Last Name:CABRERA
Suffix:
Gender:
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4460 NW 79TH AVE APT 2D
Mailing Address - Street 2:
Mailing Address - City:DORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33166-6307
Mailing Address - Country:US
Mailing Address - Phone:786-495-6620
Mailing Address - Fax:
Practice Address - Street 1:4460 NW 79TH AVE APT 2D
Practice Address - Street 2:
Practice Address - City:DORAL
Practice Address - State:FL
Practice Address - Zip Code:33166-6307
Practice Address - Country:US
Practice Address - Phone:786-495-6620
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-14
Last Update Date:2025-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11038065363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily