Healthcare Provider Details

I. General information

NPI: 1487945085
Provider Name (Legal Business Name): TERESITA DE JESUS CUETO OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/29/2011
Last Update Date: 04/23/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7575 SW 32ND ST
MIAMI FL
33155-2751
US

IV. Provider business mailing address

8567 CORAL WAY # 451
MIAMI FL
33155-2335
US

V. Phone/Fax

Practice location:
  • Phone: 786-853-3308
  • Fax: 786-388-8483
Mailing address:
  • Phone: 786-853-3308
  • Fax: 786-388-8483

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XL0004X
TaxonomyLow Vision Occupational Therapist
License NumberOT10075
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: