Provider Demographics
NPI:1609155456
Name:CUELLAR, PEDRO (MPH)
Entity Type:Individual
Prefix:MR
First Name:PEDRO
Middle Name:
Last Name:CUELLAR
Suffix:
Gender:M
Credentials:MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 367476
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00936-7476
Mailing Address - Country:US
Mailing Address - Phone:215-298-2823
Mailing Address - Fax:
Practice Address - Street 1:1640 CALLE TAMESIS
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00926-2953
Practice Address - Country:US
Practice Address - Phone:215-298-2823
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-10
Last Update Date:2011-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR308156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician