Provider Demographics
NPI:1306733373
Name:HERNANDEZ CEPERO, DIANEYA
Entity type:Individual
Prefix:
First Name:DIANEYA
Middle Name:
Last Name:HERNANDEZ CEPERO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7351 SW 11TH ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33144-4548
Mailing Address - Country:US
Mailing Address - Phone:786-458-0373
Mailing Address - Fax:
Practice Address - Street 1:10775 NW 50TH ST APT 304
Practice Address - Street 2:
Practice Address - City:DORAL
Practice Address - State:FL
Practice Address - Zip Code:33178-3967
Practice Address - Country:US
Practice Address - Phone:786-458-0373
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-21
Last Update Date:2025-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR24482208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice