Provider Demographics
NPI:1114322724
Name:CEDENO, EDALIA ENID (RN, MSN, CAAMA)
Entity type:Individual
Prefix:
First Name:EDALIA
Middle Name:ENID
Last Name:CEDENO
Suffix:
Gender:F
Credentials:RN, MSN, CAAMA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:URB LOS CAOBOS ALBIZIA ST. 1159
Mailing Address - Street 2:
Mailing Address - City:PONCE
Mailing Address - State:PR
Mailing Address - Zip Code:00716
Mailing Address - Country:US
Mailing Address - Phone:787-242-9173
Mailing Address - Fax:
Practice Address - Street 1:ARILLAGA ST. BLDG 587
Practice Address - Street 2:
Practice Address - City:SALINAS
Practice Address - State:PR
Practice Address - Zip Code:00751
Practice Address - Country:US
Practice Address - Phone:787-461-1973
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-10-24
Last Update Date:2014-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR29716163WG0000X
MDR166258163WM0705X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice
No163WM0705XNursing Service ProvidersRegistered NurseMedical-Surgical