Provider Demographics
NPI:1609012715
Name:CUBANO, MIGUEL ALBERTO (MD)
Entity Type:Individual
Prefix:DR
First Name:MIGUEL
Middle Name:ALBERTO
Last Name:CUBANO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17630 SE 158TH CT
Mailing Address - Street 2:
Mailing Address - City:WEIRSDALE
Mailing Address - State:FL
Mailing Address - Zip Code:32195-3158
Mailing Address - Country:US
Mailing Address - Phone:352-821-0025
Mailing Address - Fax:
Practice Address - Street 1:17630 SE 158TH CT
Practice Address - Street 2:
Practice Address - City:WEIRSDALE
Practice Address - State:FL
Practice Address - Zip Code:32195-3158
Practice Address - Country:US
Practice Address - Phone:352-821-0025
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-18
Last Update Date:2008-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD39381208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery