Healthcare Provider Details

I. General information

NPI: 1255944724
Provider Name (Legal Business Name): MS. SILVINA OCANA CEDENO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/25/2020
Last Update Date: 08/25/2020
Certification Date: 08/24/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1739 NW 4TH ST
MIAMI FL
33125-4521
US

IV. Provider business mailing address

1739 NW 4TH ST
MIAMI FL
33125-4521
US

V. Phone/Fax

Practice location:
  • Phone: 786-316-6969
  • Fax:
Mailing address:
  • Phone: 786-316-6969
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: