Gustavo A Cuello Diaz, M.D.

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

10859 Issued in PR

Practice address

4 Ernesto Ramos Antonini
Bo Amelia
Guaynabo, PR 00965

Phone

(787) 792-4308

NPI assigned

Oct 5, 2005

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in PR

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• University of Puerto Rico School of Medicine

  • General Acute Care Hospital
  • San Juan, PR
  • NPI 1750655510
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1128470400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710460800000",
    "number": "1114914074",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "U20 CALLE JASPER",
            "address_2": "URBANIZACION PARK GARDENS",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009262139",
            "telephone_number": "787-292-2018",
            "fax_number": "787-292-2018"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 ERNESTO RAMOS ANTONINI",
            "address_2": "BO AMELIA",
            "city": "GUAYNABO",
            "state": "PR",
            "postal_code": "00965",
            "telephone_number": "787-792-4308"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CUELLO DIAZ",
        "first_name": "GUSTAVO",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-05",
        "last_updated": "2024-03-15",
        "certification_date": "2024-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "PR",
            "license": "10859",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "10859",
            "state": "PR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Elisa Cruzado
• Nibaldo Antonio Cruzado, M.D.
• Gerardo Augusto Cubano Calderon, PH.D
• Miguel A Cubero Bonilla, 1244P
• Luz Milagros Cuebas, MD
• Cuerpo de Emergencias Medicas de
• Jean Carlos Cuevas Diaz
• Esther J Cuevas, PHARMACIST
• Rafael Cummings Torres, 1066P
• Maria T Curet Salim, MD

• General Practice Physician in Guaynabo, PR
• Providers in Guaynabo, PR by specialty
• General Practice Physician in Puerto Rico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.