Healthcare Provider Details

I. General information

NPI: 1033140975
Provider Name (Legal Business Name): SANDRA I AGUAYO CEDENO MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/06/2006
Last Update Date: 06/01/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

EDIF MEDICO HNAS DAVILA J16 CALLE 2 STE 110
BAYAMON PR
00959-5045
US

IV. Provider business mailing address

EDIF MEDICO HNAS DAVILA J16 CALLE 2 STE 110
BAYAMON PR
00959
US

V. Phone/Fax

Practice location:
  • Phone: 787-787-3838
  • Fax: 787-785-6975
Mailing address:
  • Phone: 787-787-3838
  • Fax: 787-785-6975

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number9894
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: