Provider Demographics
NPI:1063421352
Name:CEPERO-AKSELRAD, ANSELMO ERNESTO (MD)
Entity type:Individual
Prefix:DR
First Name:ANSELMO
Middle Name:ERNESTO
Last Name:CEPERO-AKSELRAD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:5955 PONCE DE LEON BLVD
Mailing Address - Street 2:
Mailing Address - City:CORAL GABLES
Mailing Address - State:FL
Mailing Address - Zip Code:33146-2423
Mailing Address - Country:US
Mailing Address - Phone:305-661-1515
Mailing Address - Fax:305-662-3723
Practice Address - Street 1:6200 SUNSET DR STE 303
Practice Address - Street 2:
Practice Address - City:SOUTH MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33143-4829
Practice Address - Country:US
Practice Address - Phone:305-661-4318
Practice Address - Fax:305-661-4330
Is Sole Proprietor?:No
Enumeration Date:2006-08-05
Last Update Date:2020-10-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME-00411852080P0210X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0210XAllopathic & Osteopathic PhysiciansPediatricsPediatric Nephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL064218500Medicaid
FL064218500Medicaid
FL00007807ZMedicare ID - Type UnspecifiedMEDICARE