Provider Demographics
NPI:1861748816
Name:CABRERA, BLANCA A (MT)
Entity type:Individual
Prefix:MS
First Name:BLANCA
Middle Name:A
Last Name:CABRERA
Suffix:
Gender:F
Credentials:MT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8830 BRENNAN CIR
Mailing Address - Street 2:302
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33615-6196
Mailing Address - Country:US
Mailing Address - Phone:813-525-8491
Mailing Address - Fax:
Practice Address - Street 1:6101 WEBB RD
Practice Address - Street 2:310
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33615-2872
Practice Address - Country:US
Practice Address - Phone:813-525-8491
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-27
Last Update Date:2012-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA 67512225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist