Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Q00000X | Family Doctor | 14418 | PR |
Y | 208D00000X | General Practice Physician | ACN982 | FL |
NPI | 1003946484 |
---|---|
Provider Name | Mrs. Yolanda Cubero |
First Address | Aguadilla, PR 00603 |
Second Address | Orlando, FL 32822-5806 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/03/2007 |
Last Update Date | 28/12/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
ACN982 | FLORIDA MEDICAL LICENSE (01) | FL |
BC8085828 | DEA (01) | FL |