Basic Information
Provider Information
NPI: 1104955368
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: CABRERA
FirstName: AMPARITA
MiddleName:  
NamePrefix: MRS.
NameSuffix:  
Credential: ARNP
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1042 NE 95TH ST
Address2:  
City: MIAMI SHORES
State: FL
PostalCode: 331382548
CountryCode: US
TelephoneNumber: 3057518626
FaxNumber:  
Practice Location
Address1: 5200 NE 2ND AVE
Address2:  
City: MIAMI
State: FL
PostalCode: 331372706
CountryCode: US
TelephoneNumber: 3057518626
FaxNumber:  
Other Information
ProviderEnumerationDate: 03/05/2007
LastUpdateDate: 05/22/2008
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363L00000XARNP 1085302FLY Physician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner 

No ID Information.


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