Healthcare Provider Details

I. General information

NPI: 1417078841
Provider Name (Legal Business Name): CESAR M PELLERANO MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/03/2007
Last Update Date: 04/29/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2999 NE 191ST ST SUITE 200
AVENTURA FL
33180-3123
US

IV. Provider business mailing address

2999 NE 191ST ST SUITE 200
AVENTURA FL
33180-3123
US

V. Phone/Fax

Practice location:
  • Phone: 305-933-8877
  • Fax: 305-933-3244
Mailing address:
  • Phone: 305-933-8877
  • Fax: 305-933-3244

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License NumberME35555
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: