Healthcare Provider Details

I. General information

NPI: 1558439323
Provider Name (Legal Business Name): VICTOR CUEVAS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/01/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

HCO1 BUZON 2444
LAS MARIAS PR
00670
US

IV. Provider business mailing address

HCO1 BUZON 2444
LAS MARIAS PR
00670
US

V. Phone/Fax

Practice location:
  • Phone: 787-827-4846
  • Fax:
Mailing address:
  • Phone: 787-827-4846
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number10622
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: