Healthcare Provider Details

I. General information

NPI: 1982546107
Provider Name (Legal Business Name): MR. CEASAR HIPOLITO ABRENICA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/07/2026
Last Update Date: 04/07/2026
Certification Date: 04/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 INFINITY WAY APT 1305
MOUNTAIN VIEW CA
94043-5007
US

IV. Provider business mailing address

100 INFINITY WAY APT 1305
MOUNTAIN VIEW CA
94043-5007
US

V. Phone/Fax

Practice location:
  • Phone: 904-238-0534
  • Fax:
Mailing address:
  • Phone: 831-464-5519
  • Fax: 831-464-6596

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP2201X
TaxonomyAmbulatory Care Registered Nurse
License Number9237206
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: