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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