Provider Demographics
NPI:1447438007
Name:RODOLFO J CEPERO MD PA
Entity type:Organization
Organization Name:RODOLFO J CEPERO MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:DR
Authorized Official - First Name:RODOLFO
Authorized Official - Middle Name:J
Authorized Official - Last Name:CEPERO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-251-3991
Mailing Address - Street 1:6201 SW 70TH ST
Mailing Address - Street 2:SUITE 103
Mailing Address - City:SOUTH MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33143-4718
Mailing Address - Country:US
Mailing Address - Phone:305-251-3991
Mailing Address - Fax:305-251-7982
Practice Address - Street 1:6201 SW 70TH ST
Practice Address - Street 2:SUITE 103
Practice Address - City:SOUTH MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33143-4718
Practice Address - Country:US
Practice Address - Phone:305-251-3991
Practice Address - Fax:305-251-7982
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-06
Last Update Date:2008-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLE79219Medicare UPIN
FL09595Medicare PIN