Provider Demographics
NPI:1851525513
Name:CEDENO, SUSANA M (MA)
Entity Type:Individual
Prefix:
First Name:SUSANA
Middle Name:M
Last Name:CEDENO
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3481 NW 34TH ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33142-5746
Mailing Address - Country:US
Mailing Address - Phone:786-553-3150
Mailing Address - Fax:786-422-2422
Practice Address - Street 1:3481 NW 34TH ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33142-5746
Practice Address - Country:US
Practice Address - Phone:786-553-3150
Practice Address - Fax:305-422-2422
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-11
Last Update Date:2021-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA 53469247000000X
FLOTA14150224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant
No247000000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Health Information