Healthcare Provider Details

I. General information

NPI: 1912251570
Provider Name (Legal Business Name): MARIA J CUEVAS DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/05/2012
Last Update Date: 02/23/2021
Certification Date: 02/23/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4613 DUKE ST STE B
ALEXANDRIA VA
22304-2559
US

IV. Provider business mailing address

350 NEW FIDELITY CT
GARNER NC
27529-2665
US

V. Phone/Fax

Practice location:
  • Phone: 703-751-1052
  • Fax: 703-751-1053
Mailing address:
  • Phone: 919-258-2714
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT27911
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number2305208566
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: