Most Relevant Information
Provider Data
| NPI Number: | 1003373192 |
| Provider Name: | BRAULIO JOSE CUESTA |
| Entity Type: | Individual |
| Taxonomy Code: | 390200000X |
| Specialty: | Student in an Organized Health Care Education/Training Program |
| License Number: |
Most Important Dates
| Enumeration Date: | 02/25/2019 |
| Last Updated: | 04/16/2019 |
Provider Practice Location
1215 LEE ST
CHARLOTTESVILLE
VA
229080816
Practice Location Phone/Fax
| Phone: | 4349241931 |
| Fax: | 4342435770 |
Provider Mailing Location
1215 LEE ST BOX 800744
CHARLOTTESVILLE
VA
229080816
Provider Mailing Phone/Fax
| Phone: | 4349241931 |
| Fax: | 4342435770 |