Provider Demographics
NPI:1548153307
Name:FABREGAS JIMENEZ, ORLANDO
Entity type:Individual
Prefix:
First Name:ORLANDO
Middle Name:
Last Name:FABREGAS JIMENEZ
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18135 SW 138TH CT
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33177-6450
Mailing Address - Country:US
Mailing Address - Phone:954-702-5898
Mailing Address - Fax:
Practice Address - Street 1:18135 SW 138TH CT
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33177-6450
Practice Address - Country:US
Practice Address - Phone:954-702-5898
Practice Address - Fax:954-702-5898
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-30
Last Update Date:2025-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL505920956106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician