Provider Demographics
NPI:1497747828
Name:CEDO ALZAMORA, CARLOS J (MD)
Entity Type:Individual
Prefix:MRS
First Name:CARLOS
Middle Name:J
Last Name:CEDO ALZAMORA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 3479
Mailing Address - Street 2:
Mailing Address - City:MAYAGUEZ
Mailing Address - State:PR
Mailing Address - Zip Code:00681-3479
Mailing Address - Country:US
Mailing Address - Phone:787-833-1113
Mailing Address - Fax:787-831-2380
Practice Address - Street 1:EDIF LA PALMA
Practice Address - Street 2:PERAL #14 ESQUINA DE DIEGO APT 2 F
Practice Address - City:MAYAGUEZ
Practice Address - State:PR
Practice Address - Zip Code:00680-4861
Practice Address - Country:US
Practice Address - Phone:787-833-1113
Practice Address - Fax:787-831-2380
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-22
Last Update Date:2013-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR3969207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
D08318Medicare UPIN
0025277Medicare ID - Type Unspecified