Provider Demographics
NPI:1578116612
Name:RAMIREZ CEDENO, EDGARDO CARLOS
Entity Type:Individual
Prefix:
First Name:EDGARDO
Middle Name:CARLOS
Last Name:RAMIREZ CEDENO
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:URB CITY PARADISE
Mailing Address - Street 2:53 CALLE CUPEY
Mailing Address - City:BARCELONETA
Mailing Address - State:PR
Mailing Address - Zip Code:00617-2751
Mailing Address - Country:US
Mailing Address - Phone:939-289-8035
Mailing Address - Fax:
Practice Address - Street 1:CUPEY PROFESSIONAL MALL
Practice Address - Street 2:354 CALLE SAN CLAUDIO SUITE 201
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00926
Practice Address - Country:US
Practice Address - Phone:939-289-8035
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-07-18
Last Update Date:2019-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR177175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath