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General NPI Number Information
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NPI Number | 1053505255
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Entity Type | Organization
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Legal Business Name | CARDIOVASCULAR CENTER OF MIAMI LLC
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Dates
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Enumeration Date | 08/30/2007
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Last Update Date | 01/14/2008
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Provider Practice Location Address
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Address Line | 10020 SW 40TH ST
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City | MIAMI
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State | FL
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Zip | 33165-3946
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Country | US
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Telephone | 305-487-3334
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Fax | 305-487-3323
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Provider Business Mailing Address
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Address Line | 10020 SW 40TH ST
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City | MIAMI
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State | FL
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Zip | 33165-3946
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Country | US
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Telephone | 305-487-3334
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Fax | 305-487-3323
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Authorized Official
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Title or Position | AUTHORIZED OFFICIAL
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Name | DR. JORGE LUIS CUELLO
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Credential | M.D.
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Telephone | 305-487-3334
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number |
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License Number State |
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