Healthcare Provider Details

I. General information

NPI: 1235630914
Provider Name (Legal Business Name): GUILLERMO CUE-GUIRADO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/27/2018
Last Update Date: 06/16/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3901 W 18TH AVE STE 903A
HIALEAH FL
33012-7038
US

IV. Provider business mailing address

3901 W 18TH AVE STE 903A
HIALEAH FL
33012-7038
US

V. Phone/Fax

Practice location:
  • Phone: 786-332-4846
  • Fax: 305-381-5544
Mailing address:
  • Phone: 786-332-4846
  • Fax: 305-381-5544

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code172A00000X
TaxonomyDriver
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: