Provider Demographics
NPI:1700621414
Name:CACEDA, ANDRES
Entity type:Individual
Prefix:
First Name:ANDRES
Middle Name:
Last Name:CACEDA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5481 SW 60TH ST UNIT 402
Mailing Address - Street 2:
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34474-7696
Mailing Address - Country:US
Mailing Address - Phone:352-425-0385
Mailing Address - Fax:352-608-9172
Practice Address - Street 1:5481 SW 60TH ST UNIT 402
Practice Address - Street 2:
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34474-7696
Practice Address - Country:US
Practice Address - Phone:352-425-0385
Practice Address - Fax:352-608-9172
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-26
Last Update Date:2024-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician