Healthcare Provider Details
I. General information
NPI: 1063212637
Provider Name (Legal Business Name): CESAR SEGARRA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 03/13/2025
Last Update Date: 08/25/2025
Certification Date: 08/25/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
5995 SW 71ST ST # 1A
SOUTH MIAMI FL
33143-3531
US
IV. Provider business mailing address
11518 SW 235TH ST
HOMESTEAD FL
33032-6267
US
V. Phone/Fax
- Phone: 305-669-6833
- Fax:
- Phone: 202-853-8433
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 390200000X |
| Taxonomy | Student in an Organized Health Care Education/Training Program |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208M00000X |
| Taxonomy | Hospitalist Physician |
| License Number | HSE44023 |
| License Number State | FL |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: