Provider Demographics
NPI:1821259763
Name:CUELLAR, REYNA LYNN (MD)
Entity Type:Individual
Prefix:
First Name:REYNA
Middle Name:LYNN
Last Name:CUELLAR
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:REYNA
Other - Middle Name:LYNN
Other - Last Name:FUENTES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:6285 S HIGLEY RD
Mailing Address - Street 2:
Mailing Address - City:GILBERT
Mailing Address - State:AZ
Mailing Address - Zip Code:85298-4262
Mailing Address - Country:US
Mailing Address - Phone:480-460-4949
Mailing Address - Fax:480-460-5858
Practice Address - Street 1:965 W CHANDLER HEIGHTS RD
Practice Address - Street 2:
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85248-5724
Practice Address - Country:US
Practice Address - Phone:480-460-4949
Practice Address - Fax:480-460-5858
Is Sole Proprietor?:No
Enumeration Date:2008-06-23
Last Update Date:2024-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ40187208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics