Provider Demographics
NPI:1285482133
Name:CEDENO CASTILLO, CESAR DAVID
Entity type:Individual
Prefix:
First Name:CESAR
Middle Name:DAVID
Last Name:CEDENO CASTILLO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:821 SW 3RD ST APT 1
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33130-2216
Mailing Address - Country:US
Mailing Address - Phone:786-727-5481
Mailing Address - Fax:
Practice Address - Street 1:821 SW 3RD ST APT 1
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33130-2216
Practice Address - Country:US
Practice Address - Phone:786-727-5481
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-07
Last Update Date:2024-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician