Healthcare Provider Details

I. General information

NPI: 1871757377
Provider Name (Legal Business Name): CARLOS CUADROS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/14/2008
Last Update Date: 07/14/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1601 SW ARCHER RD
GAINESVILLE FL
32608-1135
US

IV. Provider business mailing address

1601 SW ARCHER RD
GAINESVILLE FL
32608-1135
US

V. Phone/Fax

Practice location:
  • Phone: 352-374-6074
  • Fax:
Mailing address:
  • Phone: 352-374-6074
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number8957
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: