Healthcare Provider Details

I. General information

NPI: 1427542950
Provider Name (Legal Business Name): MARIOL GARCIA CUNILLERA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/18/2018
Last Update Date: 06/09/2026
Certification Date: 06/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

522 E 25TH STREET 4TH FLOOR
HIALEAH FL
33013
US

IV. Provider business mailing address

522 E 25TH STREET
HIALEAH FL
33013
US

V. Phone/Fax

Practice location:
  • Phone: 786-584-5600
  • Fax: 786-584-5699
Mailing address:
  • Phone: 786-584-5600
  • Fax: 786-584-5699

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberME148511
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: