Healthcare Provider Details
I. General information
NPI: 1639439953
Provider Name (Legal Business Name): VICTOR CUETO JR. M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 05/21/2012
Last Update Date: 11/18/2025
Certification Date: 11/18/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
15155 SW 97TH AVE STE 100
MIAMI FL
33176-0049
US
IV. Provider business mailing address
15155 SW 97TH AVE STE 100
MIAMI FL
33176-0049
US
V. Phone/Fax
- Phone: 305-689-7272
- Fax: 305-689-7273
- Phone: 305-689-7272
- Fax: 305-689-7273
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207RB0002X |
| Taxonomy | Obesity Medicine (Internal Medicine) Physician |
| License Number | ME140098 |
| License Number State | FL |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2080B0002X |
| Taxonomy | Pediatric Obesity Medicine Physician |
| License Number | ME140098 |
| License Number State | FL |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207R00000X |
| Taxonomy | Internal Medicine Physician |
| License Number | ME140098 |
| License Number State | FL |
| # 4 | |
| Primary Taxonomy | N |
| Taxonomy Code | 208000000X |
| Taxonomy | Pediatrics Physician |
| License Number | ME140098 |
| License Number State | FL |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: