Healthcare Provider Details

I. General information

NPI: 1427803527
Provider Name (Legal Business Name): MAYTEE REGLA CUEVAS ROJAS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/22/2024
Last Update Date: 08/20/2025
Certification Date: 08/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2374 NW 172ND TER
MIAMI GARDENS FL
33056-4636
US

IV. Provider business mailing address

2374 NW 172ND TER
MIAMI GARDENS FL
33056-4636
US

V. Phone/Fax

Practice location:
  • Phone: 305-342-9421
  • Fax:
Mailing address:
  • Phone: 305-342-9421
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number11032423
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number11032423
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: