MEDICARE: PATRICIA MATIAS CEDANO APRN

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	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	2023058112	FL

General Provider Information

NPI Number	:	1104652288
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PATRICIA MATIAS CEDANO APRN

Provider Business Mailing Address
First Line	:	8954 SW 226TH TER
Second Line	:
City	:	CUTLER BAY
State	:	FL
Zip	:	33190-1326
Country	:	US
Telephone Number	:	786-328-4580
Fax Number	:

Provider Business Practice Location Address
First Line	:	8954 SW 226TH TER
Second Line	:
City	:	CUTLER BAY
State	:	FL
Zip	:	33190-1326
Country	:	US
Telephone Number	:	786-328-4580
Fax Number	:

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

Provider Enumeration Date	:	09/13/2024
Last Update Date	:	09/13/2024

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