MEDICARE: DR. RODOLFO J CEPERO M.D. P.A.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RG0300X	Geriatric Medicine (Internal Medicine) Physician	ME0054264	FL

General Provider Information

NPI Number	:	1023087921
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RODOLFO J CEPERO M.D. P.A.

Provider Business Mailing Address
First Line	:	6201 SW 70TH ST
Second Line	:	SUITE 103
City	:	SOUTH MIAMI
State	:	FL
Zip	:	33143-4718
Country	:	US
Telephone Number	:	305-668-6155
Fax Number	:	305-661-2720

Provider Business Practice Location Address
First Line	:	6201 SW 70TH ST
Second Line	:	SUITE 103
City	:	SOUTH MIAMI
State	:	FL
Zip	:	33143-4718
Country	:	US
Telephone Number	:	305-668-6155
Fax Number	:	305-661-2720

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/15/2006
Last Update Date	:	02/06/2008

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