Provider Demographics
NPI:1598402505
Name:CUITIVA, SEBASTIAN (PA-C)
Entity Type:Individual
Prefix:
First Name:SEBASTIAN
Middle Name:
Last Name:CUITIVA
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4803 SW 34TH PL APT 104
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32608-3085
Mailing Address - Country:US
Mailing Address - Phone:786-352-9225
Mailing Address - Fax:
Practice Address - Street 1:1699 SW 16TH AVE BLDG A
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32608-1158
Practice Address - Country:US
Practice Address - Phone:786-352-9225
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-19
Last Update Date:2023-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program