Provider Demographics
NPI:1912229121
Name:CUADRA MONGALO, SILVIA MARIA (MD)
Entity type:Individual
Prefix:DR
First Name:SILVIA
Middle Name:MARIA
Last Name:CUADRA MONGALO
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:740 DUNLAWTON AVE
Mailing Address - Street 2:
Mailing Address - City:PORT ORANGE
Mailing Address - State:FL
Mailing Address - Zip Code:32127-4239
Mailing Address - Country:US
Mailing Address - Phone:386-763-1000
Mailing Address - Fax:386-481-6399
Practice Address - Street 1:740 DUNLAWTON AVE
Practice Address - Street 2:
Practice Address - City:PORT ORANGE
Practice Address - State:FL
Practice Address - Zip Code:32127-4239
Practice Address - Country:US
Practice Address - Phone:386-763-1000
Practice Address - Fax:386-481-6399
Is Sole Proprietor?:No
Enumeration Date:2010-02-16
Last Update Date:2021-03-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME125785207R00000X, 207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine