Healthcare Provider Details

I. General information

NPI: 1598631582
Provider Name (Legal Business Name): AXEL DANIEL CUEVAS RODRIGUEZ
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/15/2025
Last Update Date: 10/15/2025
Certification Date: 10/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2751 SW 71ST TER APT 807
DAVIE FL
33314-1119
US

IV. Provider business mailing address

2751 SW 71ST TER APT 807
DAVIE FL
33314-1119
US

V. Phone/Fax

Practice location:
  • Phone: 787-322-8963
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: