Provider Demographics
NPI:1821336975
Name:JORGE H. CAYCEDO, M.D., P.A.
Entity Type:Organization
Organization Name:JORGE H. CAYCEDO, M.D., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JORGE
Authorized Official - Middle Name:H
Authorized Official - Last Name:CAYCEDO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:305-371-9880
Mailing Address - Street 1:150 SE 2ND AVE
Mailing Address - Street 2:SUITE 1109
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33131-1518
Mailing Address - Country:US
Mailing Address - Phone:305-371-9880
Mailing Address - Fax:305-373-3616
Practice Address - Street 1:150 SE 2ND AVE
Practice Address - Street 2:SUITE 1109
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33131-1518
Practice Address - Country:US
Practice Address - Phone:305-371-9880
Practice Address - Fax:305-373-3616
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-01-24
Last Update Date:2013-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL202632084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL91893Medicare UPIN