Provider Demographics
NPI:1386479848
Name:CUERVO, DANIEL JOSE (PHARMD)
Entity type:Individual
Prefix:
First Name:DANIEL
Middle Name:JOSE
Last Name:CUERVO
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:208 WINCHESTER CT
Mailing Address - Street 2:
Mailing Address - City:WEST COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29170-1061
Mailing Address - Country:US
Mailing Address - Phone:239-220-0653
Mailing Address - Fax:
Practice Address - Street 1:5441 PLATT SPRINGS RD
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:SC
Practice Address - Zip Code:29073-9260
Practice Address - Country:US
Practice Address - Phone:803-756-6000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-04
Last Update Date:2024-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC60359183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist