Provider Demographics
NPI:1386636660
Name:CUELI, ROBERT (MD)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:
Last Name:CUELI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:315 SE 13TH ST
Mailing Address - Street 2:
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33316-1923
Mailing Address - Country:US
Mailing Address - Phone:954-767-5900
Mailing Address - Fax:954-767-6070
Practice Address - Street 1:315 SE 13TH ST
Practice Address - Street 2:
Practice Address - City:FT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33316-1923
Practice Address - Country:US
Practice Address - Phone:954-767-5900
Practice Address - Fax:954-767-6070
Is Sole Proprietor?:No
Enumeration Date:2005-08-22
Last Update Date:2009-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME60254174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL371093900Medicaid
FL15225UMedicare PIN
FL371093900Medicaid
FLF30673Medicare UPIN