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General NPI Number Information
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NPI Number | 1578664363
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Entity Type | Individual
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Provider Name | MARIO S CUERVO MD
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Gender | Male
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Dates
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Enumeration Date | 09/26/2006
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Last Update Date | 08/29/2014
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Provider Practice Location Address
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Address Line | 10200 SW 72 ST
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City | MIAMI
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State | FL
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Zip | 33173-3033
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Country | US
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Telephone | 305-630-1400
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Fax | 800-370-1116
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Provider Business Mailing Address
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Address Line | 10200 SW 72 STREET
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City | MIAMI
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State | FL
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Zip | 33143
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Country | US
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Telephone | 305-630-1400
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Fax | 800-370-1116
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | ME 0040730
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | ME0040730
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License Number State | FL
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