Ivan A. Cerezo de la Rosa, MD

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

9816 Issued in PR

Practice address

Ave. Ponce de Leon 804
Suite 304 Miramar
San Juan, PR 00907

Phone

(787) 722-6746

Fax

(787) 725-6207

NPI assigned

Mar 25, 2006

Last updated

Nov 18, 2009By the provider in NPPES

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in PR

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1143244800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1258502400000",
    "number": "1245290956",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "AVE. PONCE DE LEON 804",
            "address_2": "SUITE 304 MIRAMAR",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "00907",
            "telephone_number": "787-722-6746",
            "fax_number": "787-725-6207"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "AVE. PONCE DE LEON 804",
            "address_2": "SUITE 304 MIRAMAR",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "00907",
            "telephone_number": "787-722-6746",
            "fax_number": "787-725-6207"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CEREZO DE LA ROSA",
        "first_name": "IVAN",
        "middle_name": "A.",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-03-25",
        "last_updated": "2009-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "PR",
            "license": "9816",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Emilio Andres Cepeda
• Rosa M Cepeda
• Sonia L. Cepedahernandez, MA , PSYCHOLOGIST
• Alejandra Paola Cepero de Leon
• Sandra Patricia Cerda, D.M.D.
• Javier Antonio Cerra-Franco, MD
• Gerardo Francisco Cerra, MD
• Raquel Cervera
• Aura Nivia Cesar Almanza, M.D.
• Alice Adrienne Cesar, CRNA

• General Practice Physician in San Juan, PR
• Providers in San Juan, PR by specialty
• General Practice Physician in Puerto Rico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.