Healthcare Provider Details

I. General information

NPI: 1801860770
Provider Name (Legal Business Name): BEATRIZ CUNILL DE SAUTU
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 02/15/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3200 SW 62ND CT
MIAMI FL
33155-3069
US

IV. Provider business mailing address

3200 SW 62ND CT
MIAMI FL
33155-3069
US

V. Phone/Fax

Practice location:
  • Phone: 305-669-6505
  • Fax: 305-669-6447
Mailing address:
  • Phone: 305-669-6505
  • Fax: 305-669-6447

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code173000000X
TaxonomyLegal Medicine
License NumberME91331
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: