Provider Demographics
NPI:1780339648
Name:CUEVAS QUINTANA, YINA MARIEL (DC)
Entity type:Individual
Prefix:
First Name:YINA
Middle Name:MARIEL
Last Name:CUEVAS QUINTANA
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2500 1ST AVE N
Mailing Address - Street 2:
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33713-8702
Mailing Address - Country:US
Mailing Address - Phone:787-359-3571
Mailing Address - Fax:
Practice Address - Street 1:2500 1ST AVE N
Practice Address - Street 2:
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33713-8702
Practice Address - Country:US
Practice Address - Phone:787-359-3571
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-02-18
Last Update Date:2022-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL13940111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor