Provider Demographics
NPI:1992701858
Name:CAYCEDO, JORGE HUMBERTO (MD)
Entity type:Individual
Prefix:DR
First Name:JORGE
Middle Name:HUMBERTO
Last Name:CAYCEDO
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:150 SE 2ND AVE
Mailing Address - Street 2:STE 1109
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33131-1578
Mailing Address - Country:US
Mailing Address - Phone:305-371-9880
Mailing Address - Fax:305-373-3616
Practice Address - Street 1:150 SE 2ND AVE
Practice Address - Street 2:STE 1109
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33131-1578
Practice Address - Country:US
Practice Address - Phone:305-371-9880
Practice Address - Fax:305-373-3616
Is Sole Proprietor?:No
Enumeration Date:2005-06-24
Last Update Date:2016-01-28
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FL202632084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL91893Medicare PIN