Healthcare Provider Details

I. General information

NPI: 1396104766
Provider Name (Legal Business Name): BRISMAYDA CUTLER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/15/2016
Last Update Date: 02/15/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1120 NW 14TH ST RM 1210 UNIVERSITY OF MIAMI/EARLY STEPS PROGRAM
MIAMI FL
33136-2107
US

IV. Provider business mailing address

25430 SW 126TH CT
HOMESTEAD FL
33032-5832
US

V. Phone/Fax

Practice location:
  • Phone: 305-243-6660
  • Fax:
Mailing address:
  • Phone: 305-338-5003
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: