Healthcare Provider Details

I. General information

NPI: 1588614572
Provider Name (Legal Business Name): JUAN C CUETO MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/11/2006
Last Update Date: 10/01/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4150 NW 7TH ST SUITE 100
MIAMI FL
33126-5535
US

IV. Provider business mailing address

4150 NW 7TH ST SUITE 100
MIAMI FL
33126-5535
US

V. Phone/Fax

Practice location:
  • Phone: 305-442-1159
  • Fax: 305-442-0658
Mailing address:
  • Phone: 305-442-1159
  • Fax: 305-442-0658

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License NumberME0060255
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: