Basic Information
| Provider Information | |||||||||
| NPI: | 1033640420 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | CUERVO | ||||||||
| FirstName: | JANELLE | ||||||||
| MiddleName: | LEAH | ||||||||
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| Credential: | DO | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1611 NW 12TH AVE | ||||||||
| Address2: | SUITE CENTRAL 600-D | ||||||||
| City: | MIAMI | ||||||||
| State: | FL | ||||||||
| PostalCode: | 331361005 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3055855215 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1150 NW 14TH ST | ||||||||
| Address2: | |||||||||
| City: | MIAMI | ||||||||
| State: | FL | ||||||||
| PostalCode: | 331362137 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3052434900 | ||||||||
| FaxNumber: | 3052434966 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/27/2017 | ||||||||
| LastUpdateDate: | 07/08/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 07/08/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 390200000X | FL | N | Student, Health Care | Student in an Organized Health Care Education/Training Program | 207R00000X | OS16901 | FL | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.