Provider Demographics
NPI:1457600785
Name:MEDICAL OFFICE OF MARIA C CUBILLAS MD PA
Entity Type:Organization
Organization Name:MEDICAL OFFICE OF MARIA C CUBILLAS MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:C
Authorized Official - Last Name:CUBILLAS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:305-246-0047
Mailing Address - Street 1:27531 S DIXIE HWY
Mailing Address - Street 2:
Mailing Address - City:HOMESTEAD
Mailing Address - State:FL
Mailing Address - Zip Code:33032-8225
Mailing Address - Country:US
Mailing Address - Phone:305-246-0047
Mailing Address - Fax:305-247-8540
Practice Address - Street 1:27531 S DIXIE HWY
Practice Address - Street 2:
Practice Address - City:HOMESTEAD
Practice Address - State:FL
Practice Address - Zip Code:33032-8225
Practice Address - Country:US
Practice Address - Phone:305-246-0047
Practice Address - Fax:305-247-8540
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-08-31
Last Update Date:2012-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0055442208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL08944Medicare UPIN