Healthcare Provider Details

I. General information

NPI: 1588688923
Provider Name (Legal Business Name): MARIANELA CUADRADO M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/27/2006
Last Update Date: 10/28/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1451 AVE ASHFORD
SAN JUAN PR
00907-1511
US

IV. Provider business mailing address

HC 5 BOX 6085
AGUAS BUENAS PR
00703
US

V. Phone/Fax

Practice location:
  • Phone: 787-722-2915
  • Fax:
Mailing address:
  • Phone: 787-644-3860
  • Fax: 787-924-0751

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number14601
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: