Provider Demographics
NPI:1386705879
Name:VALDESUSO, CESAR JOSE (MD)
Entity type:Individual
Prefix:
First Name:CESAR
Middle Name:JOSE
Last Name:VALDESUSO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:CESAR
Other - Middle Name:JOSE
Other - Last Name:VALDESUSO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:232 SW 8TH ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33130-3514
Mailing Address - Country:US
Mailing Address - Phone:305-858-9997
Mailing Address - Fax:
Practice Address - Street 1:232 SW 8TH ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33130-3514
Practice Address - Country:US
Practice Address - Phone:305-858-9997
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME44120207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLA83989Medicare UPIN
A83989Medicare UPIN