Healthcare Provider Details

I. General information

NPI: 1194709014
Provider Name (Legal Business Name): LUZ MILAGROS CUEBAS MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/05/2005
Last Update Date: 12/11/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CRISALIDA 2 MUNOZ RIVERA
GUAYNABO PR
00969
US

IV. Provider business mailing address

CRISALIDA 2 MUNOZ RIVERA
GUAYNABO PR
00969
US

V. Phone/Fax

Practice location:
  • Phone: 787-720-5222
  • Fax: 787-272-0824
Mailing address:
  • Phone: 787-720-5222
  • Fax: 787-272-0824

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License Number7858
License Number StatePR
# 2
Primary TaxonomyN
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License Number159116
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: