Healthcare Provider Details

I. General information

NPI: 1760168728
Provider Name (Legal Business Name): ALFREDO CUZA RNFA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/26/2023
Last Update Date: 06/27/2023
Certification Date: 06/27/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13640 SW 22 TERR
MIAMI FL
33182
US

IV. Provider business mailing address

13640 SW 22 TERR
MIAMI FL
33182
US

V. Phone/Fax

Practice location:
  • Phone: 786-251-7333
  • Fax:
Mailing address:
  • Phone: 786-251-7333
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code246ZC0007X
TaxonomySurgical Assistant
License Number22-657
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code163WR0006X
TaxonomyRegistered Nurse First Assistant
License NumberRN9634330
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: