Provider Demographics
NPI:1770376097
Name:IRVINE-CABRERA, SOL ANGEL
Entity type:Individual
Prefix:
First Name:SOL
Middle Name:ANGEL
Last Name:IRVINE-CABRERA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15030 GRANT LN
Mailing Address - Street 2:
Mailing Address - City:HOMESTEAD
Mailing Address - State:FL
Mailing Address - Zip Code:33033-2730
Mailing Address - Country:US
Mailing Address - Phone:786-424-1835
Mailing Address - Fax:
Practice Address - Street 1:13155 SW 134TH ST STE 224
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33186-4489
Practice Address - Country:US
Practice Address - Phone:786-424-1835
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-28
Last Update Date:2025-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLBACB1190012106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician