Healthcare Provider Details

I. General information

NPI: 1740147859
Provider Name (Legal Business Name): MELISSA CUELLAR
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/08/2026
Last Update Date: 01/08/2026
Certification Date: 01/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2460 SW 137TH AVE
MIAMI FL
33175-8803
US

IV. Provider business mailing address

448 SE 37TH PL
HOMESTEAD FL
33033-6208
US

V. Phone/Fax

Practice location:
  • Phone: 305-459-3207
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number11044714
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: