=====================================================
General NPI Number Information
=====================================================
NPI Number | 1013236801
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | ANTHONY CUVA MD,PA
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/19/2010
-----------------------------------------------------
Last Update Date | 05/19/2010
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2505 MANATEE AVE W
-----------------------------------------------------
City | BRADENTON
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 34205-4935
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 941-794-0646
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 14430
-----------------------------------------------------
City | BRADENTON
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 34280-4430
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 941-794-0646
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | ANTHONY (NMN) CUVA
-----------------------------------------------------
Credential | M.D.
-----------------------------------------------------
Telephone | 941-794-0646
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 314000000X
-----------------------------------------------------
Taxonomy Name | Skilled Nursing Facility
-----------------------------------------------------
License Number | ME19231
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------