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Organization
MAXIMO L. CUETO JR. M.D.S.C.
Active
Organization
MAXIMO L. CUETO JR. M.D.S.C.
Active
Other names
none
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MAXIMO LIBRADA CUETO JR. M.D. (PRESIDENT)
(414) 282-1152
Entity
Organization
Contact information
Practice address
2745 W LAYTON AVE, SUITE 102, MILWAUKEE, WI 53221-2651
(414) 282-1152
(414) 282-5485
Mailing address
2745 W LAYTON AVE, SUITE 102, MILWAUKEE, WI 53221-2651
(414) 282-1152
(414) 282-5485
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
20379-20
WI
261QM0855X
Adolescent and Children Mental Health Clinic/Center
Primary
20379-20
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000073674
MEDICARE
WI
05
—
3010-7800
—
WI
Enumeration date
05/30/2012
Last updated
05/30/2012
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