Individual provider Active NPI

Lietty Cuellar

  • Family Nurse Practitioner
  • Hialeah, FL
National Provider Identifier
1417762972
Registry record updated Mar 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
F02250408 Issued in FL
Practice address
6036 NW 194TH St
Hialeah, FL 33015-4812
Phone
(305) 775-0728
NPI assigned
Feb 11, 2025
Reactivated
Mar 17, 2025
Last updated
Mar 17, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X F02250408 FL Primary

Addresses

Primary practice location

6036 NW 194TH St
Hialeah, FL 33015-4812

Mailing address

6036 NW 194TH St
Hialeah, FL 33015-4812
Phone (305) 775-0728

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250514003834 FL Practitioner - Nurse Practitioner 7012435936 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

1010 Carpenters Way
Lakeland, FL 33809-3926
Phone (863) 815-0488

1026 Albee Farm Rd
Venice, FL 34285-6213
Phone (941) 484-0425

10680 Old Saint Augustine Rd
Jacksonville, FL 32257-1000
Phone (904) 268-4953

1620 Helvenston St SE
Live Oak, FL 32064-3474
Phone (386) 362-7860

3001 S Congress Ave
Boynton Beach, FL 33426-9012
Phone (561) 737-5600

301 S Gloria St
Clewiston, FL 33440-3520
Phone (863) 983-5123

375 NW 51 St
Boca Raton, FL 33431-4773
Phone (561) 997-8111

390 NE 135TH St
North Miami, FL 33161-3967
Phone (305) 895-4804

4033 Beaver LN
Port Charlotte, FL 33952-9206
Phone (941) 625-3200

4405 Lakewood Rd
Lake Worth, FL 33461-3414
Phone (561) 969-1400

5245 N Socrum Loop Rd
Lakeland, FL 33809-4253
Phone (863) 859-1446

701 Victoria St
Brandon, FL 33510-4100
Phone (813) 681-4220

800 NW 95 St
Miami, FL 33150-2032
Phone (305) 836-1550

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
F02250408FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Intensive Care Experts Health Network LLC CurrentSince May 12, 2025 Accepting new patients
Intensive Care Experts Health Network LLC CurrentSince May 12, 2025 Accepting new patients

Locations

701 N Federal Hwy
Ste 601
Hallandale Beach, FL 33009
Phone (954) 573-2195

4033 Beaver Ln
Pt Charlotte, FL 33952
Phone (941) 212-2748

Organizations & group practices 2

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": "1739232000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742169600000",
    "number": "1417762972",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6036 NW 194TH ST",
            "city": "HIALEAH",
            "state": "FL",
            "postal_code": "330154812",
            "telephone_number": "305-775-0728"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6036 NW 194TH ST",
            "city": "HIALEAH",
            "state": "FL",
            "postal_code": "330154812",
            "telephone_number": "305-775-0728"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CUELLAR",
        "first_name": "LIETTY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-02-11",
        "last_updated": "2025-03-17",
        "certification_date": "2025-02-11",
        "deactivation_date": "2025-03-07",
        "reactivation_date": "2025-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "F02250408",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hialeah, FL

Sources for this page

Verify at the official NPI Registry.