Healthcare Provider Details

I. General information

NPI: 1568585313
Provider Name (Legal Business Name): MARIA JOSEFA CUELLAR MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/09/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CARR 21 #1785 URB LAS LOMAS
SAN JUAN PR
00921
US

IV. Provider business mailing address

100 LA SIERRA AVE APT 200
SAN JUAN PR
00926-4323
US

V. Phone/Fax

Practice location:
  • Phone: 787-782-9999
  • Fax: 787-782-0280
Mailing address:
  • Phone: 787-755-8077
  • Fax: 787-755-8077

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number8964
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: