Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RR0500X | Rheumatology | ME 96445 | FL |
NPI | 1053320861 |
---|---|
Provider Name | Dr. Marta Lucia Cuellar |
First Address | New Smyrna Beach, FL 32169-2069 |
Second Address | North Miami Beach, FL 33169-5513 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 08/08/2006 |
Last Update Date | 10/11/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1483761 | (05) | FL |
AB002X | (02) | FL |