Provider Demographics
NPI:1356578629
Name:CUETO, GABRIEL E (MD)
Entity type:Individual
Prefix:
First Name:GABRIEL
Middle Name:E
Last Name:CUETO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:3300 S FISKE BLVD
Mailing Address - Street 2:
Mailing Address - City:ROCKLEDGE
Mailing Address - State:FL
Mailing Address - Zip Code:32955-4306
Mailing Address - Country:US
Mailing Address - Phone:321-434-8121
Mailing Address - Fax:321-951-7408
Practice Address - Street 1:1425 MALABAR RD NE
Practice Address - Street 2:
Practice Address - City:PALM BAY
Practice Address - State:FL
Practice Address - Zip Code:32907-2506
Practice Address - Country:US
Practice Address - Phone:321-434-1242
Practice Address - Fax:321-434-5244
Is Sole Proprietor?:No
Enumeration Date:2009-06-15
Last Update Date:2023-09-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME113606207Q00000X, 208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL006104400Medicaid
FLGI754XOtherMEDICARE
FL006104400Medicaid
FLKR888OtherMEDICARE PTAN