Healthcare Provider Details

I. General information

NPI: 1326778564
Provider Name (Legal Business Name): JOSE JOEL CUEVAS MHC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: JOSE JOEL CUEVAS MA

II. Dates (important events)

Enumeration Date: 06/11/2022
Last Update Date: 11/26/2025
Certification Date: 11/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

145 E 13TH ST
SAINT CLOUD FL
34769-4749
US

IV. Provider business mailing address

1530 ELMWOOD AVE
KISSIMMEE FL
34744-4009
US

V. Phone/Fax

Practice location:
  • Phone: 407-749-3580
  • Fax:
Mailing address:
  • Phone: 689-241-0833
  • 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: