Healthcare Provider Details

I. General information

NPI: 1598402505
Provider Name (Legal Business Name): SEBASTIAN CUITIVA PA-C
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/19/2022
Last Update Date: 06/04/2025
Certification Date: 06/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6201 W NEWBERRY RD
GAINESVILLE FL
32605-4305
US

IV. Provider business mailing address

13498 NW 2ND LN APT 302
NEWBERRY FL
32669-3668
US

V. Phone/Fax

Practice location:
  • Phone: 352-265-9465
  • Fax:
Mailing address:
  • Phone: 786-352-9225
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: