Male or Other

Dr. Jose G. Cevallos M.D.

Internal Medicine Physician in Fort Lauderdale, FL(View on Map)

Full Name

Dr. Jose Gustavo Cevallos M.D.

NPI Number

1922236736

NPI Type

Individual Provider

Gender

Male

Enumeration Date

06/30/2009

Specialties

(Taxonomies)

Code

207R00000X

Primary Taxonomy

Yes

Licenses

State

Florida
Texas

License Number

ME114288
U5083

Contact
Information

Purpose

Mailing
Location

Address

5353 N FEDERAL HWY STE 400406
5353 N FEDERAL HWY STE 400

City

Fort Lauderdale
Fort Lauderdale

State

FL
FL

Postal Code

33308-3245
33308-3244

Country

US
US

Telephone Number

(954) 938-2843
(954) 938-2843

Identifiers

Identifier

U5083
011046600
ME114288

Identifier State

TX
FL
FL

Identifier Issuer

TEXAS MEDICAL LICENSE
Unknown
FLORIDA MEDICAL LICENSE

Provider data last refreshed from NPPES NPI registry on 11/19/2024

Data last updated by provider on 01/01/2024

Provider Address

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