Provider Demographics
NPI:1083468532
Name:CUETO-SALGADO, LIZETH ROCIO
Entity Type:Individual
Prefix:
First Name:LIZETH
Middle Name:ROCIO
Last Name:CUETO-SALGADO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:LIZETH
Other - Middle Name:ROCIO
Other - Last Name:CUETO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:4312 ALTURA MESA LN NE
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87110-5059
Mailing Address - Country:US
Mailing Address - Phone:575-703-1457
Mailing Address - Fax:
Practice Address - Street 1:1 UNIVERSITY OF NEW MEXICO MSC09 5030
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87131-0001
Practice Address - Country:US
Practice Address - Phone:505-272-8244
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-12
Last Update Date:2024-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program