Provider Demographics
NPI:1447098884
Name:GALI CABRERA, LESTHER J
Entity type:Individual
Prefix:
First Name:LESTHER
Middle Name:J
Last Name:GALI CABRERA
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 1:12831 SW 43RD DR APT 249A
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33175-4169
Mailing Address - Country:US
Mailing Address - Phone:786-352-5812
Mailing Address - Fax:
Practice Address - Street 1:12831 SW 43RD DR APT 249A
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33175-4169
Practice Address - Country:US
Practice Address - Phone:786-352-5812
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-18
Last Update Date:2024-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-24-361942106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior TechnicianGroup - Single Specialty