Provider Demographics
NPI:1700513991
Name:CUEVAS CRUZ, JULIO MANUEL
Entity Type:Individual
Prefix:
First Name:JULIO
Middle Name:MANUEL
Last Name:CUEVAS CRUZ
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:788 CREEKWATER TER APT 210
Mailing Address - Street 2:
Mailing Address - City:LAKE MARY
Mailing Address - State:FL
Mailing Address - Zip Code:32746-6064
Mailing Address - Country:US
Mailing Address - Phone:787-501-5949
Mailing Address - Fax:
Practice Address - Street 1:788 CREEKWATER TER APT 210
Practice Address - Street 2:
Practice Address - City:LAKE MARY
Practice Address - State:FL
Practice Address - Zip Code:32746-6064
Practice Address - Country:US
Practice Address - Phone:787-501-5949
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-07
Last Update Date:2022-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program