MEDICARE: WILMA E CEDENO MD

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	208D00000X	General Practice Physician	13658	PR

General Provider Information

NPI Number	:	1871696799
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	WILMA E CEDENO MD

Provider Business Mailing Address
First Line	:	PMB 12
Second Line	:	P.O. BOX 6022
City	:	CAROLINA
State	:	PR
Zip	:	00988-6022
Country	:	US
Telephone Number	:	787-360-4600
Fax Number	:	787-754-1059

Provider Business Practice Location Address
First Line	:	1700 CALLE SANTA AGUEDA
Second Line	:	URB. SAN GERARDO
City	:	SAN JUAN
State	:	PR
Zip	:	00926-4312
Country	:	US
Telephone Number	:	787-754-1059
Fax Number	:

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

Provider Enumeration Date	:	09/06/2006
Last Update Date	:	07/08/2007

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Directions to “ WILMA E CEDENO MD” Practice Location

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