Individual provider Active NPI

Maria Fernanda Cuellar, PT

  • Physical Therapist
  • Port St Lucie, FL
National Provider Identifier
1508113952
Registry record updated Dec 29, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT18972 Issued in FL
Practice address
8414 S Federal Hwy
Port St Lucie, FL 34952-3306
Phone
(772) 446-9047
Fax
(772) 879-6650
NPI assigned
Aug 4, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 29, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT18972 FL Primary

Addresses

Primary practice location

8414 S Federal Hwy
Port St Lucie, FL 34952-3306

Mailing address

PO Box 880594
Port St Lucie, FL 34988-0594
Phone (772) 446-9047

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT18972FLMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Smart Living Florida Current 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": "1344038400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609200000000",
    "number": "1508113952",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 880594",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349880594",
            "telephone_number": "772-446-9047",
            "fax_number": "772-879-6650"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8414 S FEDERAL HWY",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349523306",
            "telephone_number": "772-446-9047",
            "fax_number": "772-879-6650"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CUELLAR",
        "first_name": "MARIA",
        "middle_name": "FERNANDA",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-08-04",
        "last_updated": "2020-12-29",
        "certification_date": "2020-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT18972",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port St Lucie, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2020; 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.