Healthcare Provider Details

I. General information

NPI: 1780952762
Provider Name (Legal Business Name): ADELAIDA D CUETO MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ADELAIDA D CUETO MD

II. Dates (important events)

Enumeration Date: 12/06/2011
Last Update Date: 09/13/2024
Certification Date: 09/13/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16420 NW 59TH AVE
MIAMI LAKES FL
33014-5602
US

IV. Provider business mailing address

5045 SW 87TH PL
MIAMI FL
33165-6744
US

V. Phone/Fax

Practice location:
  • Phone: 786-817-2415
  • Fax:
Mailing address:
  • Phone: 786-817-2415
  • Fax: 786-651-2177

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberME147961
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: