Provider Demographics
NPI:1265628176
Name:CUELLO-SUAREZ, ROSA M (MD)
Entity type:Individual
Prefix:
First Name:ROSA
Middle Name:M
Last Name:CUELLO-SUAREZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1840 FOREST HILL BLVD
Mailing Address - Street 2:STE 100
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33406-6063
Mailing Address - Country:US
Mailing Address - Phone:561-964-5161
Mailing Address - Fax:561-232-3086
Practice Address - Street 1:1840 FOREST HILL BLVD
Practice Address - Street 2:STE 100
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33406-6063
Practice Address - Country:US
Practice Address - Phone:561-964-5161
Practice Address - Fax:561-232-3086
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-25
Last Update Date:2015-04-01
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FLME0071562207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLE95916Medicare UPIN