Healthcare Provider Details

I. General information

NPI: 1518780170
Provider Name (Legal Business Name): SOFIA CUETO AP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/04/2024
Last Update Date: 11/04/2024
Certification Date: 11/03/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

960 W 41ST ST STE 208
MIAMI BEACH FL
33140-3349
US

IV. Provider business mailing address

1532 SW 23RD ST
MIAMI FL
33145-3951
US

V. Phone/Fax

Practice location:
  • Phone: 305-343-0700
  • Fax:
Mailing address:
  • Phone: 305-343-0700
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberAP4058
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: