Provider Demographics
NPI:1174226112
Name:SANCHEZ CUELLAR, ANDRES
Entity type:Individual
Prefix:
First Name:ANDRES
Middle Name:
Last Name:SANCHEZ CUELLAR
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 1:6445 W 24TH AVE APT 2
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33016-3981
Mailing Address - Country:US
Mailing Address - Phone:561-568-1235
Mailing Address - Fax:
Practice Address - Street 1:6222 SW 8TH ST
Practice Address - Street 2:
Practice Address - City:WEST MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33144-4810
Practice Address - Country:US
Practice Address - Phone:305-221-5115
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-27
Last Update Date:2023-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11019467363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily