MEDICARE: DR. JORGE HUMBERTO CAYCEDO M.D.

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	2084P0800X	Psychiatry Physician	20263	FL

General Provider Information

NPI Number	:	1992701858
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JORGE HUMBERTO CAYCEDO M.D.

Provider Business Mailing Address
First Line	:	150 SE 2ND AVE
Second Line	:	STE 1109
City	:	MIAMI
State	:	FL
Zip	:	33131-1578
Country	:	US
Telephone Number	:	305-371-9880
Fax Number	:	305-373-3616

Provider Business Practice Location Address
First Line	:	150 SE 2ND AVE
Second Line	:	STE 1109
City	:	MIAMI
State	:	FL
Zip	:	33131-1578
Country	:	US
Telephone Number	:	305-371-9880
Fax Number	:	305-373-3616

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

Provider Enumeration Date	:	06/24/2005
Last Update Date	:	01/28/2016

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