Individual provider Active NPI

Jessica Adriana Ayala Cuesta, MD

  • Pediatrics Physician
  • Port Charlotte, FL
National Provider Identifier
1316424716
Registry record updated Feb 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
ME170917 Issued in FL
Practice address
4300 Kings Hwy
Port Charlotte, FL 33980-2917
Phone
(844) 342-7935
NPI assigned
Jul 27, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 11, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X ME170917 FL Primary

Addresses

Primary practice location

4300 Kings Hwy
Port Charlotte, FL 33980-2917

Mailing address

100 Woods Rd BLDG 1N-J08
Valhalla, NY 10595-1530
Phone (914) 493-7997

Other practice location 1

Boulevard Dr Guillermo Arbona
San Juan, PR 00935-0001
Phone (787) 474-0333 ext. 7141

Other practice location 2

100 Woods Rd
Valhalla, NY 10595-1530
Phone (914) 493-7997

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
ME170917FLMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Family Health Centers of Southwest Florida Inc PastSince Feb 23, 2025 Accepting new patients

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1532649600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739232000000",
    "number": "1316424716",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 WOODS RD BLDG 1N-J08",
            "city": "VALHALLA",
            "state": "NY",
            "postal_code": "105951530",
            "telephone_number": "914-493-7997",
            "fax_number": "914-449-2402"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4300 KINGS HWY",
            "city": "PORT CHARLOTTE",
            "state": "FL",
            "postal_code": "339802917",
            "telephone_number": "844-342-7935"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "Boulevard Dr Guillermo Arbona",
            "address_purpose": "LOCATION",
            "city": "San Juan",
            "state": "PR",
            "postal_code": "009350001",
            "country_code": "US",
            "telephone_number": "787-474-0333 x7141",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "100 Woods Rd",
            "address_purpose": "LOCATION",
            "city": "Valhalla",
            "state": "NY",
            "postal_code": "105951530",
            "country_code": "US",
            "telephone_number": "914-493-7997",
            "fax_number": "914-449-2402",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "AYALA CUESTA",
        "first_name": "JESSICA",
        "middle_name": "ADRIANA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-07-27",
        "last_updated": "2025-02-11",
        "certification_date": "2025-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "FL",
            "license": "ME170917",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Charlotte, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2025; 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.