Healthcare Provider Details
I. General information
NPI: 1790368074
Provider Name (Legal Business Name): CARLOS CUETO MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 05/04/2021
Last Update Date: 05/04/2021
Certification Date: 05/04/2021
Deactivation Date:
Reactivation Date:
III. Provider practice location address
4300 ALTON RD
MIAMI BEACH FL
33140-2948
US
IV. Provider business mailing address
4300 ALTON RD
MIAMI BEACH FL
33140-2948
US
V. Phone/Fax
- Phone: 305-674-2273
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 390200000X |
| Taxonomy | Student in an Organized Health Care Education/Training Program |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: