Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 102L00000X | Psychologist | ||
Y | 103T00000X | Psychologist |
NPI | 1013332428 |
---|---|
Provider Name | Rudy Cepero |
First Address | Hialeah, FL 33016-2601 |
Second Address | Hialeah, FL 33016-2601 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/02/2014 |
Last Update Date | 20/02/2014 |