Basic Information
Provider Information
NPI: 1477795854
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: CESAR
FirstName: JOSUE
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: LPN
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 11031 NE 6TH AVE
Address2:  
City: MIAMI
State: FL
PostalCode: 331617182
CountryCode: US
TelephoneNumber: 3053986100
FaxNumber: 3057574465
Practice Location
Address1: 3830 W FLAGLER ST
Address2:  
City: CORAL GABLES
State: FL
PostalCode: 331341604
CountryCode: US
TelephoneNumber: 3054421453
FaxNumber: 3054421466
Other Information
ProviderEnumerationDate: 03/31/2009
LastUpdateDate: 03/31/2009
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
164W00000XPN5184960FLY Nursing Service ProvidersLicensed Practical Nurse 

No ID Information.


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