Healthcare Provider Details

I. General information

NPI: 1316792922
Provider Name (Legal Business Name): JESSICA FERNANDA CUERO RCSWI
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/18/2024
Last Update Date: 08/08/2025
Certification Date: 08/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7369 SHERIDAN ST STE 101
HOLLYWOOD FL
33024-2776
US

IV. Provider business mailing address

7261 SHERIDAN ST STE 340
HOLLYWOOD FL
33024-2726
US

V. Phone/Fax

Practice location:
  • Phone: 954-561-6222
  • Fax: 954-990-7650
Mailing address:
  • Phone: 954-561-6222
  • Fax: 954-990-7650

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberSW25179
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: