Healthcare Provider Details

I. General information

NPI: 1114072782
Provider Name (Legal Business Name): MICHAEL STEVEN CUENCA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/24/2007
Last Update Date: 03/10/2025
Certification Date: 03/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1740 E HALLANDALE BEACH BLVD
HALLANDALE BEACH FL
33009-4611
US

IV. Provider business mailing address

6101 BLUE LAGOON DR STE 200
MIAMI FL
33126-3168
US

V. Phone/Fax

Practice location:
  • Phone: 954-456-5533
  • Fax: 888-204-4839
Mailing address:
  • Phone: 305-500-2000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number153581
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberME 78467
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: