Provider Demographics
NPI:1134584543
Name:CUBERO REGO, DAVID BIENVENIDO (MD)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:BIENVENIDO
Last Name:CUBERO REGO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 117287
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30368-7287
Mailing Address - Country:US
Mailing Address - Phone:239-432-8331
Mailing Address - Fax:813-321-1296
Practice Address - Street 1:2848 CENTER POINTE DR STE A
Practice Address - Street 2:
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33916-9521
Practice Address - Country:US
Practice Address - Phone:239-561-9622
Practice Address - Fax:239-768-5297
Is Sole Proprietor?:No
Enumeration Date:2015-12-30
Last Update Date:2021-06-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME141818207ZP0102X, 207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology