Provider Demographics
NPI:1174903686
Name:FUNDORA CABRERA, MARIA LILIA (DPM)
Entity type:Individual
Prefix:
First Name:MARIA
Middle Name:LILIA
Last Name:FUNDORA CABRERA
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1380 NE MIAMI GARDENS DR 209
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33179-4709
Mailing Address - Country:US
Mailing Address - Phone:305-945-7575
Mailing Address - Fax:305-945-7585
Practice Address - Street 1:1380 NE MIAMI GARDENS DR 209
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33179-4709
Practice Address - Country:US
Practice Address - Phone:305-945-7575
Practice Address - Fax:305-945-7585
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-01
Last Update Date:2015-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPO3683213ES0131X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot Surgery