Organization
G&A PROFESSIONAL HEALTH SERVICES PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GABRIEL E CUETO MD (OWNER)
(305) 934-8592
Entity
Organization
Contact information
Practice address
3682 N WICKHAM RD STE B1-306, MELBOURNE, FL 32935-2325
(305) 934-8592
Mailing address
3682 N WICKHAM RD STE B1-300, MELBOURNE, FL 32935-2325
(305) 934-8592
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
—
—
208M00000X
Hospitalist Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
101946200
—
FL
01
—
DY8543
RRMEDICARE PTAN
FL
01
—
KR887
MEDICARE PTAN
FL
Enumeration date
10/09/2018
Last updated
03/29/2023
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