Healthcare Provider Details

I. General information

NPI: 1184402588
Provider Name (Legal Business Name): CESAR POMARES MILLAN RN
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/18/2023
Last Update Date: 09/18/2023
Certification Date: 09/18/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2985 DREW ST
CLEARWATER FL
33759-3012
US

IV. Provider business mailing address

8504 CACHE DR
SARASOTA FL
34240-2709
US

V. Phone/Fax

Practice location:
  • Phone: 727-820-8200
  • Fax:
Mailing address:
  • Phone: 832-360-7198
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number834377
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: