Provider Demographics
NPI:1245876176
Name:CEDANO RAMIREZ, BERNARDA ANTONIETA (PA)
Entity type:Individual
Prefix:
First Name:BERNARDA
Middle Name:ANTONIETA
Last Name:CEDANO RAMIREZ
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:280 WHIRLAWAY DR
Mailing Address - Street 2:
Mailing Address - City:DAVENPORT
Mailing Address - State:FL
Mailing Address - Zip Code:33837-3652
Mailing Address - Country:US
Mailing Address - Phone:318-990-6676
Mailing Address - Fax:
Practice Address - Street 1:280 WHIRLAWAY DR
Practice Address - Street 2:
Practice Address - City:DAVENPORT
Practice Address - State:FL
Practice Address - Zip Code:33837-3652
Practice Address - Country:US
Practice Address - Phone:318-990-6676
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-11-26
Last Update Date:2025-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL19-457246ZC0007X
VA0136001005246ZC0007X
DC5108246ZC0007X
PR2838363A00000X, 363AS0400X
IL238000672246ZC0007X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Assistant
No363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical