Provider Demographics
NPI:1588688923
Name:CUADRADO, MARIANELA (MD)
Entity type:Individual
Prefix:DR
First Name:MARIANELA
Middle Name:
Last Name:CUADRADO
Suffix:
Gender:F
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:HC 5 BOX 6085
Mailing Address - Street 2:
Mailing Address - City:AGUAS BUENAS
Mailing Address - State:PR
Mailing Address - Zip Code:00703
Mailing Address - Country:US
Mailing Address - Phone:787-644-3860
Mailing Address - Fax:787-924-0751
Practice Address - Street 1:1451 AVE ASHFORD
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00907-1511
Practice Address - Country:US
Practice Address - Phone:787-722-2915
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-27
Last Update Date:2016-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR14601208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR0022470Medicare ID - Type UnspecifiedPROVIDER#