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Miss Mariela Cristina Cuebas Fantauzzi, MD
General Practice Physician in Avon Park, Florida
NPI 1629571146

Mariela Cristina Cuebas Fantauzzi is a General Practice Physician based in Winter Haven, FL. Mariela Cristina Cuebas Fantauzzi practices in Avon Park, FL and has the professional credentials of MD. The NPI Number for Mariela Cristina Cuebas Fantauzzi is 1629571146 and holds a License No. 6065629 (Florida).

The current practice location address for Mariela Cristina Cuebas Fantauzzi is 950 County Road 17A W, Avon Park, FL and can be reached out via phone at 866-234-8534.

Location: 950 County Road 17A W, Avon Park, FL, 33881-4672
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1629571146
Provider Name
Mariela Cristina Cuebas Fantauzzi
Credential
MD
Provider Entity Type
Individual
Gender
Female
Address
950 County Road 17A W, Avon Park, FL, 33881-4672
Phone Number
866-234-8534
Fax Number
Provider Enumeration Date
03/11/2018
Last Update Date
10/19/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
123550500 05 FL
Z8H8N 01 FL BCBS
institution
Provider Business Practice Location Address Details
Address
950 County Road 17A W
City
Avon Park
State
Florida
Zip
33825-2164
Phone Number
866-234-8534
Fax Number
person
Provider Business Mailing Address Details
Address
950 County Road 17A W
City
Avon Park
State
Florida
Zip
33825-2164
Phone Number
866-234-8534
Fax Number
person
Provider's Taxonomy Details 1
Type
Allopathic & Osteopathic Physicians
Classification
General Practice
Speciality
-
Taxonomy
208D00000X
License No.
ACN1643 (Florida)
Definition
Definition to come...
person
Provider's Taxonomy Details 2
Type
Student, Health Care
Classification
Student in an Organized Health Care Education/Training Program
Speciality
-
Taxonomy
390200000X
License No.
6065629 ()
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
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