Provider Demographics
NPI:1609822865
Name:DADIVAS, CECILE CATALAN (MD)
Entity type:Individual
Prefix:
First Name:CECILE
Middle Name:CATALAN
Last Name:DADIVAS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6101 BLUE LAGOON DR STE 200
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33126-3168
Mailing Address - Country:US
Mailing Address - Phone:828-998-1779
Mailing Address - Fax:877-270-9477
Practice Address - Street 1:105 RIVER HILLS RD STE A
Practice Address - Street 2:
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28805-2571
Practice Address - Country:US
Practice Address - Phone:828-998-1779
Practice Address - Fax:877-270-9477
Is Sole Proprietor?:No
Enumeration Date:2006-05-26
Last Update Date:2024-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301069821207Q00000X
NC2005-00359207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCNNZ051N975OtherMEDICARE
MIN72760007Medicare ID - Type UnspecifiedWA FOOTE MEMORIAL
MIP00220196OtherRR MEDICARE