Healthcare Provider Details

I. General information

NPI: 1932414968
Provider Name (Legal Business Name): CESAR ALBERTO LLANOS M.D
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/14/2010
Last Update Date: 09/08/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1611 NW 12TH AVE
MIAMI FL
33136-1005
US

IV. Provider business mailing address

1500 SW 4TH AVE
MIAMI FL
33129-1001
US

V. Phone/Fax

Practice location:
  • Phone: 858-349-3853
  • Fax:
Mailing address:
  • Phone: 858-349-3853
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number13993
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number116630
License Number StateFL
# 3
Primary TaxonomyY
Taxonomy Code207ZP0102X
TaxonomyAnatomic Pathology & Clinical Pathology Physician
License NumberME116630
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: