Provider Demographics
NPI:1154142651
Name:CUETO, CRYSTAL M (APRN)
Entity type:Individual
Prefix:
First Name:CRYSTAL
Middle Name:M
Last Name:CUETO
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2675 WINKLER AVE FL 2
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33901-9342
Mailing Address - Country:US
Mailing Address - Phone:877-856-3774
Mailing Address - Fax:239-368-4664
Practice Address - Street 1:60 WESTMINSTER ST N STE A
Practice Address - Street 2:
Practice Address - City:LEHIGH ACRES
Practice Address - State:FL
Practice Address - Zip Code:33936-6518
Practice Address - Country:US
Practice Address - Phone:239-368-1808
Practice Address - Fax:239-368-4664
Is Sole Proprietor?:No
Enumeration Date:2024-10-18
Last Update Date:2025-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11035882363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily