Provider Demographics
NPI:1568984755
Name:CEDANO, CARLOS E
Entity Type:Individual
Prefix:
First Name:CARLOS
Middle Name:E
Last Name:CEDANO
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 1:293 SPRING CIR
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33410-6331
Mailing Address - Country:US
Mailing Address - Phone:561-281-9838
Mailing Address - Fax:800-766-3139
Practice Address - Street 1:293 SPRING CIR
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33410-6331
Practice Address - Country:US
Practice Address - Phone:561-281-9838
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-07-10
Last Update Date:2018-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician