Provider Demographics
NPI:1508461500
Name:CUETO GARCIA, ANDYS (RPH)
Entity Type:Individual
Prefix:
First Name:ANDYS
Middle Name:
Last Name:CUETO GARCIA
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:520 NW 114TH AVE APT 204
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33172-3577
Mailing Address - Country:US
Mailing Address - Phone:305-989-6460
Mailing Address - Fax:
Practice Address - Street 1:10761 W FLAGLER ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33174-1421
Practice Address - Country:US
Practice Address - Phone:305-223-3405
Practice Address - Fax:305-551-1092
Is Sole Proprietor?:No
Enumeration Date:2020-11-30
Last Update Date:2020-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL56899183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist