Organization Active NPI

G&a Professional Health Services PLLC

  • Hospitalist Physician
  • Melbourne, FL
National Provider Identifier
1417422288
Registry record updated Mar 29, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
Legal business name
G&A PROFESSIONAL HEALTH SERVICES PLLC
Practice address
3682 N Wickham Rd Ste B1-306
Melbourne, FL 32935-2325
Phone
(305) 934-8592
NPI assigned
Oct 9, 2018
Last updated
Mar 29, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 29, 2023

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

Authorized official

Name
Gabriel E Cueto, MDNPI 1356578629
Title
Owner
Phone
(305) 934-8592

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X
Hospitalist PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208M00000X Primary

Addresses

Primary practice location

3682 N Wickham Rd Ste B1-306
Melbourne, FL 32935-2325

Mailing address

3682 N Wickham Rd Ste B1-300
Melbourne, FL 32935-2325
Phone (305) 934-8592

Other identifiers 3

IdentifierTypeStateIssuer
KR887OtherFLMEDICARE PTAN
DY8543OtherFLRRMEDICARE PTAN
101946200MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190201002659 FL Part B Supplier - Clinic/Group Practice 5092052712 Receives reassigned benefits from 1 practitioner
Practice locations: Melbourne, FL; Palm Bay, FL

National Provider Directory

National Provider Directory

Locations

3682 N Wickham Rd
Ste B1300
Melbourne, FL 32935

3682 N Wickham Rd
Ste B1306
Melbourne, FL 32935
Phone (305) 934-8592

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1539043200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1680048000000",
    "number": "1417422288",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3682 N WICKHAM RD STE B1-300",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329352325",
            "telephone_number": "305-934-8592"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3682 N WICKHAM RD STE B1-306",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329352325",
            "telephone_number": "305-934-8592"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "G&A PROFESSIONAL HEALTH SERVICES PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-10-09",
        "last_updated": "2023-03-29",
        "certification_date": "2023-03-29",
        "status": "A",
        "authorized_official_last_name": "CUETO",
        "authorized_official_first_name": "GABRIEL",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "305-934-8592",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Hospitalist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "KR887",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RRMEDICARE PTAN",
            "identifier": "DY8543",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "101946200",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Melbourne, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.