Provider Demographics
NPI:1629684204
Name:CUESTA, KAROLYNA N
Entity Type:Individual
Prefix:
First Name:KAROLYNA
Middle Name:N
Last Name:CUESTA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1501 NW 108TH AVE APT 323
Mailing Address - Street 2:
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33322-6905
Mailing Address - Country:US
Mailing Address - Phone:754-281-3766
Mailing Address - Fax:
Practice Address - Street 1:4330 W BROWARD BLVD STE I
Practice Address - Street 2:
Practice Address - City:PLANTATION
Practice Address - State:FL
Practice Address - Zip Code:33317-3753
Practice Address - Country:US
Practice Address - Phone:561-774-8225
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-19
Last Update Date:2024-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health