| Doctor Name: | DR. GUSTAVO A CUELLO DIAZ |
| NPI Number: | 1114914074 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | M.D. |
| License Number: | 10859 |
| Business Practice Address: | 6 Calle Rubi Barrio Amelia Guaynabo, PR - 009655468 |
| Business Phone Number: | 7877924308 |
| Business Fax Number: | 7877924308 |
| Mailing Address: | U20 Calle Jasper, Urbanizacion Park Gardens SAN JUAN |
| State: | PR |
| Postal Code: | 009262139 |
| Phone Number: | 7872922018 |
| Fax Number: | 7872922018 |
| NPI Enumeration Date: | 10/05/2005 |
| NPI Last Update Date: | 10/12/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | 10859 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | PR |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |