Healthcare Provider Details
I. General information
NPI: 1801104930
Provider Name (Legal Business Name): ALMA ATA LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 09/23/2010
Last Update Date: 12/09/2018
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
9260 HAMMOCKS BLVD STE 201
MIAMI FL
33196
US
IV. Provider business mailing address
9260 HAMMOCKS BLVD STE 201
MIAMI FL
33196-1584
US
V. Phone/Fax
- Phone: 786-292-2329
- Fax: 786-292-2290
- Phone: 786-292-2329
- Fax: 786-292-2290
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207RB0002X |
| Taxonomy | Obesity Medicine (Internal Medicine) Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
RICHARD
CUELLO FUENTES
Title or Position: MANAGER
Credential: MD
Phone: 305-859-7719