Provider Demographics
NPI:1689491441
Name:CEDENO REYES, ANA MADALYS
Entity type:Individual
Prefix:
First Name:ANA
Middle Name:MADALYS
Last Name:CEDENO REYES
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 1:8201 PETERS RD STE 1000
Mailing Address - Street 2:
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33324-3266
Mailing Address - Country:US
Mailing Address - Phone:754-285-3261
Mailing Address - Fax:754-285-3262
Practice Address - Street 1:8201 PETERS RD STE 1000
Practice Address - Street 2:
Practice Address - City:PLANTATION
Practice Address - State:FL
Practice Address - Zip Code:33324-3266
Practice Address - Country:US
Practice Address - Phone:754-285-3261
Practice Address - Fax:754-285-3262
Is Sole Proprietor?:No
Enumeration Date:2024-09-23
Last Update Date:2025-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11035426363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily