Healthcare Provider Details

I. General information

NPI: 1184456535
Provider Name (Legal Business Name): KARINA MARIE OQUENDO CUEVAS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/15/2024
Last Update Date: 05/13/2026
Certification Date: 05/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

30740 CR 54 SUITE 122
WESLEY CHAPEL FL
33543
US

IV. Provider business mailing address

30740 CR 54 SUITE 122
WESLEY CHAPEL FL
33543
US

V. Phone/Fax

Practice location:
  • Phone: 813-377-4151
  • Fax: 813-212-5214
Mailing address:
  • Phone: 813-377-4151
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAPRN11034679
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: