Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2081P2900X | Pain Medicine | ME71375 | FL |
NPI | 1073581799 |
---|---|
Provider Name | Ramon Luis Cuevas-Trisan |
First Address | Palm Beach Gardens, FL 33418-1700 |
Second Address | Riviera Beach, FL 33410-7417 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/03/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
G39423 | (02) | FL |