Healthcare Provider Details

I. General information

NPI: 1295298420
Provider Name (Legal Business Name): NATALIE ELIZABETH CESPEDES
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/14/2019
Last Update Date: 03/20/2020
Certification Date: 03/20/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19 TACOMA ST
WORCESTER MA
01605-3516
US

IV. Provider business mailing address

9005 NW 147TH TER
MIAMI LAKES FL
33018-7304
US

V. Phone/Fax

Practice location:
  • Phone: 800-853-2288
  • Fax:
Mailing address:
  • Phone: 305-733-7601
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: