Provider Demographics
NPI:1336241611
Name:CADIZ FIGUEROA, CECILO JOSE
Entity Type:Individual
Prefix:
First Name:CECILO
Middle Name:JOSE
Last Name:CADIZ FIGUEROA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1265
Mailing Address - Street 2:
Mailing Address - City:AIBONITO
Mailing Address - State:PR
Mailing Address - Zip Code:00705-1265
Mailing Address - Country:US
Mailing Address - Phone:787-640-8104
Mailing Address - Fax:
Practice Address - Street 1:EDIF PROFESIONAL MEDICO OFICINA 103 HOSPITAL MENONITA
Practice Address - Street 2:CALLE C VAZQUEZ BO CAONILLAS
Practice Address - City:AIBONITO
Practice Address - State:PR
Practice Address - Zip Code:00705
Practice Address - Country:US
Practice Address - Phone:787-735-8001
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-05
Last Update Date:2018-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR8719208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR0029412Medicare ID - Type Unspecified
PRD32324Medicare UPIN