Provider Demographics
NPI:1558401877
Name:CUEVAS, IVAN GARCIA (MD)
Entity Type:Individual
Prefix:DR
First Name:IVAN
Middle Name:GARCIA
Last Name:CUEVAS
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:VILLAS DE LA PLAYA LUQUILLO 382
Mailing Address - Street 2:
Mailing Address - City:VEGA BAJA
Mailing Address - State:PR
Mailing Address - Zip Code:00693-0000
Mailing Address - Country:US
Mailing Address - Phone:787-403-4135
Mailing Address - Fax:787-815-3465
Practice Address - Street 1:BO MORAFLORES
Practice Address - Street 2:CARR 638 KM 6
Practice Address - City:ARECIBO
Practice Address - State:PR
Practice Address - Zip Code:00612-0000
Practice Address - Country:US
Practice Address - Phone:787-815-3465
Practice Address - Fax:787-815-3465
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PR13864208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR100157OtherMMM HEALTHCARE
PR897097836OtherMCS INSURANCE
PR4263OtherPREFERRED MEDICARE CHOICE
PR21961OtherTRIPLE S OF PUERTO RICO
PR6590076OtherHUMANA
PR21961OtherTRIPLE S OF PUERTO RICO