Healthcare Provider Details

I. General information

NPI: 1811638950
Provider Name (Legal Business Name): AMILCAR CUEVAS JR. CRNA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/05/2022
Last Update Date: 02/19/2025
Certification Date: 02/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

809 VERANDA PL
CELEBRATION FL
34747-4622
US

IV. Provider business mailing address

809 VERANDA PL
CELEBRATION FL
34747-4622
US

V. Phone/Fax

Practice location:
  • Phone: 727-667-3276
  • Fax:
Mailing address:
  • Phone: 727-667-3276
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberAPRN11018188
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: