Provider Demographics
NPI:1295428407
Name:CEDENO, ROYMARA
Entity type:Individual
Prefix:
First Name:ROYMARA
Middle Name:
Last Name:CEDENO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7861 JUBILEE PARK BLVD APT 2422
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32822-5259
Mailing Address - Country:US
Mailing Address - Phone:305-783-7450
Mailing Address - Fax:407-750-5201
Practice Address - Street 1:1416 SIMPSON RD
Practice Address - Street 2:
Practice Address - City:KISSIMMEE
Practice Address - State:FL
Practice Address - Zip Code:34744-4600
Practice Address - Country:US
Practice Address - Phone:321-947-8923
Practice Address - Fax:407-750-5201
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-01
Last Update Date:2023-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician