Healthcare Provider Details

I. General information

NPI: 1740858752
Provider Name (Legal Business Name): PAMELA CUEBAS MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/15/2021
Last Update Date: 07/31/2024
Certification Date: 07/31/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3520 38TH AVE N
ST PETERSBURG FL
33713-1448
US

IV. Provider business mailing address

3251 N MCMULLEN BOOTH RD STE 303
CLEARWATER FL
33761-2022
US

V. Phone/Fax

Practice location:
  • Phone: 727-471-5039
  • Fax:
Mailing address:
  • Phone: 727-725-6110
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberME167928
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: