Healthcare Provider Details

I. General information

NPI: 1831203249
Provider Name (Legal Business Name): DEBORAH CUADRA M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/19/2006
Last Update Date: 10/03/2022
Certification Date: 10/03/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2318 MANATEE AVE W
BRADENTON FL
34205-5432
US

IV. Provider business mailing address

101 RIVERFRONT BLVD STE 710
BRADENTON FL
34205-8812
US

V. Phone/Fax

Practice location:
  • Phone: 941-714-7150
  • Fax: 941-405-1145
Mailing address:
  • Phone: 941-776-4000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberME81821
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: