1205437514 NPI number — JULIO ALBERTO CEDENO ALICEA PHARMD

Table of content: JULIO ALBERTO CEDENO ALICEA PHARMD (NPI 1205437514)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1205437514 NPI number — JULIO ALBERTO CEDENO ALICEA PHARMD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
CEDENO ALICEA
Provider First Name:
JULIO
Provider Middle Name:
ALBERTO
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
PHARMD
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1205437514
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
11/03/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
URB. PALACIO IMPERIAL
Provider Second Line Business Mailing Address:
CALLE PERSIA 1404
Provider Business Mailing Address City Name:
TOA ALTA
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00953
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-421-6295
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
CARR. 174 KM. 10.2
Provider Second Line Business Practice Location Address:
SEC. LA MORENITA BO. GUARAGUAO
Provider Business Practice Location Address City Name:
BAYAMON
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00956
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-780-7383
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
11/03/2020

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 183500000X , with the licence number:  6597 , registered in the state of PR ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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