Provider Demographics
NPI:1568585313
Name:CUELLAR, MARIA JOSEFA (MD)
Entity Type:Individual
Prefix:MRS
First Name:MARIA
Middle Name:JOSEFA
Last Name:CUELLAR
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:100 LA SIERRA AVE
Mailing Address - Street 2:APT 200
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00926-4323
Mailing Address - Country:US
Mailing Address - Phone:787-755-8077
Mailing Address - Fax:787-755-8077
Practice Address - Street 1:CARR 21 #1785
Practice Address - Street 2:URB LAS LOMAS
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00921
Practice Address - Country:US
Practice Address - Phone:787-782-9999
Practice Address - Fax:787-782-0280
Is Sole Proprietor?:No
Enumeration Date:2007-04-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PR8964208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
G57713Medicare UPIN
PR84441Medicare ID - Type Unspecified