Provider Demographics
NPI:1124339700
Name:CESAR A VELILLA MD PA
Entity type:Organization
Organization Name:CESAR A VELILLA MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CESAR
Authorized Official - Middle Name:A
Authorized Official - Last Name:VELILLA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:786-970-8010
Mailing Address - Street 1:12709 MIRAMAR PKWY
Mailing Address - Street 2:
Mailing Address - City:MIRAMAR
Mailing Address - State:FL
Mailing Address - Zip Code:33027-2902
Mailing Address - Country:US
Mailing Address - Phone:786-970-8010
Mailing Address - Fax:305-715-9888
Practice Address - Street 1:12709 MIRAMAR PKWY
Practice Address - Street 2:
Practice Address - City:MIRAMAR
Practice Address - State:FL
Practice Address - Zip Code:33027-2902
Practice Address - Country:US
Practice Address - Phone:786-970-8010
Practice Address - Fax:305-715-9888
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-29
Last Update Date:2010-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty