Provider Demographics
NPI:1114226941
Name:MARIA LUISA S CUEVAS
Entity Type:Organization
Organization Name:MARIA LUISA S CUEVAS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:
Authorized Official - First Name:MARIA LUISA
Authorized Official - Middle Name:S
Authorized Official - Last Name:CUEVAS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:419-698-4642
Mailing Address - Street 1:1050 ISSAC STS
Mailing Address - Street 2:SUITE 104
Mailing Address - City:OREGON
Mailing Address - State:OH
Mailing Address - Zip Code:43616-3291
Mailing Address - Country:US
Mailing Address - Phone:419-698-4642
Mailing Address - Fax:
Practice Address - Street 1:7550 LUCERNE DR
Practice Address - Street 2:SUITE 405
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44130-6588
Practice Address - Country:US
Practice Address - Phone:800-556-6236
Practice Address - Fax:440-234-3313
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-18
Last Update Date:2011-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH4029101207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0323171Medicaid