Healthcare Provider Details

I. General information

NPI: 1487414918
Provider Name (Legal Business Name): LILIANA CUETO AGUIAR CBHCM
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/21/2024
Last Update Date: 03/21/2024
Certification Date: 03/21/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

900 E 9TH ST
HIALEAH FL
33010-4650
US

IV. Provider business mailing address

900 E 9TH ST
HIALEAH FL
33010-4650
US

V. Phone/Fax

Practice location:
  • Phone: 305-381-5294
  • Fax: 786-685-2266
Mailing address:
  • Phone: 305-381-5294
  • Fax: 786-685-2266

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License NumberCBHCM.104222
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: