Healthcare Provider Details

I. General information

NPI: 1457128597
Provider Name (Legal Business Name): YOUSYS CUETO CORZO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/08/2023
Last Update Date: 01/06/2025
Certification Date: 12/18/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8180 NW 36TH ST STE 317
DORAL FL
33166-6674
US

IV. Provider business mailing address

8180 NW 36TH ST STE 317
DORAL FL
33166-6674
US

V. Phone/Fax

Practice location:
  • Phone: 786-652-1513
  • Fax:
Mailing address:
  • Phone: 178-628-7403
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberRBT-23-310737
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: