Provider Demographics
NPI:1396036083
Name:CEDILLO, DANIEL
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:
Last Name:CEDILLO
Suffix:
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 1:1720 S BELLAIRE ST
Mailing Address - Street 2:325
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80222-4304
Mailing Address - Country:US
Mailing Address - Phone:866-801-9492
Mailing Address - Fax:
Practice Address - Street 1:1720 S BELLAIRE ST
Practice Address - Street 2:325
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80222-4304
Practice Address - Country:US
Practice Address - Phone:866-801-9492
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-28
Last Update Date:2011-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO192706163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse