Healthcare Provider Details

I. General information

NPI: 1275320467
Provider Name (Legal Business Name): MIKA ANGELA CUENCA SARENO M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/22/2025
Last Update Date: 12/22/2025
Certification Date: 12/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 EAST CARROLL STREET TIDALHEALTH PENINSULA REGINAL
SALISBURY MD
21801
US

IV. Provider business mailing address

100 EAST CARROLL STREET TIDALHEALTH PENINSULA REGINAL
SALISBURY MD
21801
US

V. Phone/Fax

Practice location:
  • Phone: 410-543-7106
  • Fax: 410-543-7321
Mailing address:
  • Phone: 410-543-7106
  • Fax: 410-543-7321

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: