Healthcare Provider Details

I. General information

NPI: 1801683024
Provider Name (Legal Business Name): MAXIEL CUEVAS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/22/2025
Last Update Date: 04/22/2025
Certification Date: 04/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12507 MIRAMAR PKWY BLDG G
MIRAMAR FL
33027-2909
US

IV. Provider business mailing address

1900 SANS SOUCI BLVD APT 418
NORTH MIAMI FL
33181-3041
US

V. Phone/Fax

Practice location:
  • Phone: 754-280-3569
  • Fax:
Mailing address:
  • Phone: 786-774-1696
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: