Healthcare Provider Details

I. General information

NPI: 1396664173
Provider Name (Legal Business Name): ANDREA SOFIA CEDENO MARTINEZ
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/14/2026
Last Update Date: 07/14/2026
Certification Date: 07/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1781 PARK CENTER DR STE 210
ORLANDO FL
32835-6254
US

IV. Provider business mailing address

1781 PARK CENTER DR STE 210
ORLANDO FL
32835-6254
US

V. Phone/Fax

Practice location:
  • Phone: 407-351-0675
  • Fax:
Mailing address:
  • Phone: 407-351-0675
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number3027
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: