Provider Demographics
NPI:1164192555
Name:VERA CEPERO, ROSANGEL
Entity Type:Individual
Prefix:
First Name:ROSANGEL
Middle Name:
Last Name:VERA CEPERO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:170 ROYAL PALM RD APT 101
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33016-4627
Mailing Address - Country:US
Mailing Address - Phone:786-780-5086
Mailing Address - Fax:
Practice Address - Street 1:170 ROYAL PALM RD APT 101
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33016-4627
Practice Address - Country:US
Practice Address - Phone:786-780-5086
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-16
Last Update Date:2021-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician