Healthcare Provider Details

I. General information

NPI: 1477435436
Provider Name (Legal Business Name): CARLOS MANUEL CUETO HERNANDEZ RBT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/22/2025
Last Update Date: 07/22/2025
Certification Date: 07/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3531 SW 4TH ST
MIAMI FL
33135-2503
US

IV. Provider business mailing address

3531 SW 4TH ST
MIAMI FL
33135-2503
US

V. Phone/Fax

Practice location:
  • Phone: 305-522-9310
  • Fax:
Mailing address:
  • Phone: 305-522-9310
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: