Provider Demographics
NPI:1205437514
Name:CEDENO ALICEA, JULIO ALBERTO (PHARMD)
Entity type:Individual
Prefix:
First Name:JULIO
Middle Name:ALBERTO
Last Name:CEDENO ALICEA
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:URB. PALACIO IMPERIAL
Mailing Address - Street 2:CALLE PERSIA 1404
Mailing Address - City:TOA ALTA
Mailing Address - State:PR
Mailing Address - Zip Code:00953
Mailing Address - Country:US
Mailing Address - Phone:787-421-6295
Mailing Address - Fax:
Practice Address - Street 1:CARR. 174 KM. 10.2
Practice Address - Street 2:SEC. LA MORENITA BO. GUARAGUAO
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00956
Practice Address - Country:US
Practice Address - Phone:787-780-7383
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-03
Last Update Date:2020-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR6597183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist