Healthcare Provider Details

I. General information

NPI: 1528747425
Provider Name (Legal Business Name): LIEV CEPERO HERNANDEZ MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/17/2023
Last Update Date: 07/01/2026
Certification Date: 07/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13320 SW 128TH ST
MIAMI FL
33186-5899
US

IV. Provider business mailing address

HC 2 BOX 9802
LAS MARIAS PR
00670-9023
US

V. Phone/Fax

Practice location:
  • Phone: 305-299-3934
  • Fax:
Mailing address:
  • Phone: 305-299-3934
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License NumberACN1567
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: