Provider Demographics
NPI:1164921748
Name:CEDENO-MORALES, JOSE RAMON SR
Entity Type:Individual
Prefix:
First Name:JOSE
Middle Name:RAMON
Last Name:CEDENO-MORALES
Suffix:SR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:525 RANTOUL LN
Mailing Address - Street 2:
Mailing Address - City:LAKE MARY
Mailing Address - State:FL
Mailing Address - Zip Code:32746-4203
Mailing Address - Country:US
Mailing Address - Phone:407-732-1701
Mailing Address - Fax:
Practice Address - Street 1:525 RANTOUL LN
Practice Address - Street 2:
Practice Address - City:LAKE MARY
Practice Address - State:FL
Practice Address - Zip Code:32746-4203
Practice Address - Country:US
Practice Address - Phone:407-732-1701
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-02-08
Last Update Date:2018-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program