Healthcare Provider Details

I. General information

NPI: 1104488618
Provider Name (Legal Business Name): CARLOS ANANIAS CEDENO MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: CARLOS A CEDENO MD

II. Dates (important events)

Enumeration Date: 07/03/2019
Last Update Date: 07/08/2026
Certification Date: 07/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

501 SE OSCEOLA ST STE 301
STUART FL
34994-2347
US

IV. Provider business mailing address

501 SE OSCEOLA ST STE 301
STUART FL
34994-2347
US

V. Phone/Fax

Practice location:
  • Phone: 772-419-2162
  • Fax:
Mailing address:
  • Phone: 772-419-2162
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License NumberME179739
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: