MEDICARE: ADELAIDA C CUETO MD CORP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician

General Provider Information

NPI Number	:	1689427536
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ADELAIDA C CUETO MD CORP

Provider Business Mailing Address
First Line	:	5045 SW 87TH PL
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33165-6744
Country	:	US
Telephone Number	:	786-817-2415
Fax Number	:

Provider Business Practice Location Address
First Line	:	16420 NW 59TH AVE
Second Line	:
City	:	MIAMI LAKES
State	:	FL
Zip	:	33014-5602
Country	:	US
Telephone Number	:	786-817-2415
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	ADELAIDA D CUETO
Credential	:	MD
Telephone Number	:	786-817-2415

Provider Enumeration Date	:	04/10/2024
Last Update Date	:	04/10/2024

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