Basic Information
Provider Information
NPI: 1063788677
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: OCHOA PEREZ
FirstName: CESAR
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 743144
Address2:  
City: ATLANTA
State: GA
PostalCode: 303743144
CountryCode: US
TelephoneNumber: 7865962000
FaxNumber:  
Practice Location
Address1: 1228 S PINE ISLAND RD STE 410
Address2:  
City: PLANTATION
State: FL
PostalCode: 333244583
CountryCode: US
TelephoneNumber: 9548371490
FaxNumber: 9548371188
Other Information
ProviderEnumerationDate: 03/28/2012
LastUpdateDate: 10/01/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 10/01/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207RH0003XME125204FLY Allopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology

No ID Information.


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