Provider Demographics
NPI:1518926864
Name:CESPEDES, YVANA PATRICIA (MD)
Entity Type:Individual
Prefix:
First Name:YVANA
Middle Name:PATRICIA
Last Name:CESPEDES
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 CRANBERRY HL STE 105
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:MA
Mailing Address - Zip Code:02421-7397
Mailing Address - Country:US
Mailing Address - Phone:800-325-7284
Mailing Address - Fax:205-579-9387
Practice Address - Street 1:1 CRANBERRY HL STE 105
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:MA
Practice Address - Zip Code:02421-7397
Practice Address - Country:US
Practice Address - Phone:800-325-7284
Practice Address - Fax:205-579-9387
Is Sole Proprietor?:No
Enumeration Date:2006-03-23
Last Update Date:2024-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0077410207R00000X, 207ZP0102X
MA261538207ZD0900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZD0900XAllopathic & Osteopathic PhysiciansPathologyDermatopathology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL264088100Medicaid
FLE4178XMedicare ID - Type Unspecified