MEDICARE: BRIAN CESPEDES HIS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	237700000X	Hearing Instrument Specialist	AS5755	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1215642772
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRIAN CESPEDES HIS

Provider Business Mailing Address
First Line	:	2140 58TH AVE
Second Line	:
City	:	VERO BEACH
State	:	FL
Zip	:	32966-4647
Country	:	US
Telephone Number	:	772-617-4488
Fax Number	:	772-494-1417

Provider Business Practice Location Address
First Line	:	12193 PEMBROKE RD
Second Line	:
City	:	PEMBROKE PINES
State	:	FL
Zip	:	33025-1727
Country	:	US
Telephone Number	:	954-435-8820
Fax Number	:	954-450-8185

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/19/2023
Last Update Date	:	04/14/2026

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