Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207L00000X | Anesthesiologist | UO1972 | FL |
NPI | 1992952675 |
---|---|
Provider Name | Dr. Justin Robert Cueto |
First Address | Gainesville, FL 32610-3003 |
Second Address | St Petersburg, FL 33716-3447 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 25/08/2008 |
Last Update Date | 15/04/2009 |