Healthcare Provider Details

I. General information

NPI: 1033672894
Provider Name (Legal Business Name): SOLMAIRE CUETO-GONZALEZ NP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/09/2019
Last Update Date: 04/09/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2700 SW 97TH AVE
MIAMI FL
33165-2675
US

IV. Provider business mailing address

2700 SW 97TH AVE
MIAMI FL
33165-2675
US

V. Phone/Fax

Practice location:
  • Phone: 305-704-8626
  • Fax:
Mailing address:
  • Phone: 305-704-7646
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN9381096
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: