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NPI Code Detail

MEDICARE: MARIA ALEJANDRA CEPEDA OTA

MEDICARE: MARIA ALEJANDRA CEPEDA OTA
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
1224Z00000XOccupational Therapy Assistant17943FL

General Provider Information

NPI Number : 1588262737
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARIA ALEJANDRA CEPEDA OTA
Provider Business Mailing Address
First Line : 1483 SW BOUGAINVILLEA AVE
Second Line :
City : PORT SAINT LUCIE
State : FL
Zip : 34953-7302
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1483 SW BOUGAINVILLEA AVE
Second Line :
City : PORT SAINT LUCIE
State : FL
Zip : 34953-7302
Country : US
Telephone Number : 772-336-6928
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/10/2020
Last Update Date : 10/10/2020

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