MEDICARE: ALEJANDRO G CEPERO R.R.T.

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	227900000X	Registered Respiratory Therapist	RT11706	FL

General Provider Information

NPI Number	:	1285986455
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALEJANDRO G CEPERO R.R.T.

Provider Business Mailing Address
First Line	:	2420 JOHNSON ST APT 206
Second Line	:
City	:	HOLLYWOOD
State	:	FL
Zip	:	33020-3945
Country	:	US
Telephone Number	:	754-204-4637
Fax Number	:

Provider Business Practice Location Address
First Line	:	2420 JOHNSON ST APT 206
Second Line	:
City	:	HOLLYWOOD
State	:	FL
Zip	:	33020-3945
Country	:	US
Telephone Number	:	754-204-4637
Fax Number	:

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

Provider Enumeration Date	:	10/11/2012
Last Update Date	:	10/11/2012

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