Provider Demographics
NPI:1790294502
Name:CUEVAS FELIZ, ERIT ENMANUEL (SA-C)
Entity Type:Individual
Prefix:
First Name:ERIT
Middle Name:ENMANUEL
Last Name:CUEVAS FELIZ
Suffix:
Gender:M
Credentials:SA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6471 COW PEN RD APT 210
Mailing Address - Street 2:
Mailing Address - City:MIAMI LAKES
Mailing Address - State:FL
Mailing Address - Zip Code:33014-7609
Mailing Address - Country:US
Mailing Address - Phone:786-393-3119
Mailing Address - Fax:
Practice Address - Street 1:6471 COW PEN ROAD
Practice Address - Street 2:APT 210
Practice Address - City:MIAMI LAKES
Practice Address - State:FL
Practice Address - Zip Code:33014
Practice Address - Country:US
Practice Address - Phone:786-393-3119
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-09-25
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL17-476246ZC0007X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Assistant