Healthcare Provider Details

I. General information

NPI: 1962149401
Provider Name (Legal Business Name): ARIEL CEPERO DEL SOL MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/17/2022
Last Update Date: 07/16/2026
Certification Date: 07/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4390 66TH ST N
KENNETH CITY FL
33709-4920
US

IV. Provider business mailing address

1000 E DOVE AVE
MCALLEN TX
78504-3974
US

V. Phone/Fax

Practice location:
  • Phone: 727-513-4100
  • Fax:
Mailing address:
  • Phone: 956-362-3546
  • Fax: 956-362-3237

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License NumberBP20089447
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License NumberBP10085603
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: