Provider Demographics
NPI:1427348127
Name:CUEBAS, LYNNETTE
Entity type:Individual
Prefix:
First Name:LYNNETTE
Middle Name:
Last Name:CUEBAS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4615 PHILLIPS HWY
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32207-7265
Mailing Address - Country:US
Mailing Address - Phone:904-739-7092
Mailing Address - Fax:904-730-8296
Practice Address - Street 1:4615 PHILLIPS HWY
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32207-7265
Practice Address - Country:US
Practice Address - Phone:904-739-7092
Practice Address - Fax:904-730-8296
Is Sole Proprietor?:No
Enumeration Date:2011-04-14
Last Update Date:2016-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker