Organization Active NPI

Mario S. Cuervo MD PA

  • Psychiatry Physician
  • Miami, FL
National Provider Identifier
1285958355
Registry record updated Aug 29, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
ME0040730 Issued in FL
Legal business name
MARIO S. CUERVO MD PA
Practice address
10200 SW 72 Street
Miami, FL 33173-3033
Phone
(305) 630-1400
Fax
(800) 370-1116
NPI assigned
Mar 18, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 29, 2014

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

Authorized official

Name
Dr. Mario S Cuervo, MD
Title
Owner/President
Phone
(305) 661-9598

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193200000X MULTI-SPECIALTY GROUP 174400000X ME0040730 FL
Psychiatry PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084P0800X ME0040730 FL Primary

Addresses

Primary practice location

10200 SW 72 Street
Miami, FL 33173-3033

Mailing address

10200 SW 72 Street
Miami, FL 33143
Phone (305) 630-1400

Other identifiers 2

IdentifierTypeStateIssuer
067087100MedicaidFL
0670871MedicaidFL

National Provider Directory

National Provider Directory

Locations

8600 NW 41st St
Ste 201
Doral, FL 33166
Phone (305) 541-5366

10200 SW 72nd St
Miami, FL 33173
Phone (305) 630-1400

5830 SW 73rd St
Fl First
South Miami, FL 33143
Phone (305) 661-9588

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1268870400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1409270400000",
    "number": "1285958355",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10200 SW 72 STREET",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "33143",
            "telephone_number": "305-630-1400",
            "fax_number": "800-370-1116"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10200 SW 72 STREET",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331733033",
            "telephone_number": "305-630-1400",
            "fax_number": "800-370-1116"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARIO S. CUERVO MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-03-18",
        "last_updated": "2014-08-29",
        "status": "A",
        "authorized_official_last_name": "CUERVO",
        "authorized_official_first_name": "MARIO",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "305-661-9598",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": "FL",
            "license": "ME0040730",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "FL",
            "license": "ME0040730",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "067087100",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0670871",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.