Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | ME0070399 | FL |
N | 111NI0900X | Internist | ME0070399 | FL |
Y | 207RC0000X | Internist - Cardiovascular Disease | ME0070399 | FL |
NPI | 1003855511 |
---|---|
Provider Name | Dr. Jorge Luis Cuello |
First Address | South Miami, FL 33143-4828 |
Second Address | South Miami, FL 33143-4828 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/06/2006 |
Last Update Date | 05/10/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
251437100 | (05) | FL |
G02744 | (02) |