Provider Demographics
NPI:1598402505
Name:CUITIVA, SEBASTIAN (PA-C)
Entity type:Individual
Prefix:
First Name:SEBASTIAN
Middle Name:
Last Name:CUITIVA
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13498 NW 2ND LN APT 302
Mailing Address - Street 2:
Mailing Address - City:NEWBERRY
Mailing Address - State:FL
Mailing Address - Zip Code:32669-3668
Mailing Address - Country:US
Mailing Address - Phone:786-352-9225
Mailing Address - Fax:
Practice Address - Street 1:6201 W NEWBERRY RD
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32605-4305
Practice Address - Country:US
Practice Address - Phone:352-265-9465
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-19
Last Update Date:2025-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant