Provider Demographics
NPI:1932458205
Name:ERNESTO CEPERO, O.D., P.A.
Entity Type:Organization
Organization Name:ERNESTO CEPERO, O.D., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:ERNESTO
Authorized Official - Middle Name:
Authorized Official - Last Name:CEPERO
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:305-858-4085
Mailing Address - Street 1:1705 CORAL WAY
Mailing Address - Street 2:
Mailing Address - City:CORAL GABLES
Mailing Address - State:FL
Mailing Address - Zip Code:33145-2728
Mailing Address - Country:US
Mailing Address - Phone:305-858-4085
Mailing Address - Fax:305-858-4053
Practice Address - Street 1:1705 CORAL WAY
Practice Address - Street 2:
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33145-2728
Practice Address - Country:US
Practice Address - Phone:305-858-4085
Practice Address - Fax:305-858-4053
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-09-02
Last Update Date:2012-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOPC4698152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty