Provider Demographics
NPI:1780841809
Name:CEPIN PLASENCIO, KAYRA ALTAGRACIA (MD)
Entity Type:Individual
Prefix:
First Name:KAYRA
Middle Name:ALTAGRACIA
Last Name:CEPIN PLASENCIO
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 1:7261 SHERIDAN ST STE 100D
Mailing Address - Street 2:
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33024-2708
Mailing Address - Country:US
Mailing Address - Phone:954-534-7696
Mailing Address - Fax:954-534-7731
Practice Address - Street 1:7261 SHERIDAN ST STE 100D
Practice Address - Street 2:
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33024-2708
Practice Address - Country:US
Practice Address - Phone:954-534-7696
Practice Address - Fax:954-534-7731
Is Sole Proprietor?:No
Enumeration Date:2008-05-16
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME112208207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL022764400Medicaid
FLME112208OtherMEDICAL LICENSE
FLME112208OtherMEDICAL LICENSE