MEDICARE: MR. WALTER CEDENO JR. RBT

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	106S00000X	Behavior Technician

General Provider Information

NPI Number	:	1881587582
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. WALTER CEDENO JR. RBT

Provider Business Mailing Address
First Line	:	1611 N MAIN ST
Second Line	:
City	:	KISSIMMEE
State	:	FL
Zip	:	34744-3304
Country	:	US
Telephone Number	:	407-785-1009
Fax Number	:	407-264-6443

Provider Business Practice Location Address
First Line	:	1611 N MAIN ST
Second Line	:
City	:	KISSIMMEE
State	:	FL
Zip	:	34744-3304
Country	:	US
Telephone Number	:	407-785-1009
Fax Number	:	407-264-6443

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

Provider Enumeration Date	:	05/31/2025
Last Update Date	:	05/31/2025

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