Basic Information
Provider Information
NPI: 1922385665
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: CESAR
FirstName: ORBE
MiddleName: LUIS
NamePrefix: MR.
NameSuffix: JR.
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 14961 SW 59TH ST
Address2:  
City: MIAMI
State: FL
PostalCode: 331932056
CountryCode: US
TelephoneNumber: 3524155345
FaxNumber:  
Practice Location
Address1: 10300 SW 72ND ST STE 114
Address2:  
City: MIAMI
State: FL
PostalCode: 331733038
CountryCode: US
TelephoneNumber: 3055085580
FaxNumber: 7869137034
Other Information
ProviderEnumerationDate: 11/09/2011
LastUpdateDate: 03/08/2019
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
106S00000XRBT-18-63802FLY    

No ID Information.


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