MEDICARE: DR. MAYTE CEPEDA

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	103TC0700X	Clinical Psychologist	3739	PR

General Provider Information

NPI Number	:	1881907996
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MAYTE CEPEDA

Provider Business Mailing Address
First Line	:	PO BOX 748
Second Line	:
City	:	MAYAGUEZ
State	:	PR
Zip	:	00681-0748
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	AVE LAS AMERICAS
Second Line	:
City	:	PONCE
State	:	PR
Zip	:	00717-2107
Country	:	US
Telephone Number	:	787-479-3785
Fax Number	:

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

Provider Enumeration Date	:	07/17/2010
Last Update Date	:	12/22/2011

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Directions to “ DR. MAYTE CEPEDA ” Practice Location

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