Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207V00000X | Obstetrician & Gynecologist | ME 71206 | FL |
NPI | 1013020205 |
---|---|
Provider Name | Luisa Cueto |
First Address | Boca Raton, FL 33428-2231 |
Second Address | Boca Raton, FL 33428-2231 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/08/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2511436 | (05) | FL |
G31814 | (02) | FL |