Provider Demographics
NPI:1831506542
Name:M CUESTA TORRES MD PA
Entity type:Organization
Organization Name:M CUESTA TORRES MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:
Authorized Official - Last Name:CUESTA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:786-615-2713
Mailing Address - Street 1:5941 NW 173RD DR
Mailing Address - Street 2:SUITE B-6
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33015-5109
Mailing Address - Country:US
Mailing Address - Phone:786-615-2713
Mailing Address - Fax:786-615-3023
Practice Address - Street 1:5941 NW 173RD DR
Practice Address - Street 2:SUITE B-6
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33015-5109
Practice Address - Country:US
Practice Address - Phone:786-615-2713
Practice Address - Fax:786-615-3023
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-14
Last Update Date:2014-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME438957207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty