Provider Demographics
NPI:1992751234
Name:CUEBAS, LILLIAN (LAC)
Entity type:Individual
Prefix:
First Name:LILLIAN
Middle Name:
Last Name:CUEBAS
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5108 SW 138TH AVENUE CIR
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33175-5116
Mailing Address - Country:US
Mailing Address - Phone:305-554-7621
Mailing Address - Fax:
Practice Address - Street 1:5108 SW 138TH AVENUE CIR
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33175-5116
Practice Address - Country:US
Practice Address - Phone:305-554-7621
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAP1148171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist