Provider Demographics
NPI:1467031526
Name:CERNA VIACAVA, RENATO (MD)
Entity type:Individual
Prefix:
First Name:RENATO
Middle Name:
Last Name:CERNA VIACAVA
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:655 WEST 8TH STREET, CARDIOVASCULAR CENTER, 5TH FLOOR
Mailing Address - Street 2:AMBULATORY CARE CENTER, BOX C-35
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32209
Mailing Address - Country:US
Mailing Address - Phone:904-244-3932
Mailing Address - Fax:
Practice Address - Street 1:655 WEST 8TH STREET, CARDIOVASCULAR CENTER, 5TH FLOOR
Practice Address - Street 2:AMBULATORY CARE CENTER, BOX C-35
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32209
Practice Address - Country:US
Practice Address - Phone:904-244-3932
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-06
Last Update Date:2025-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4351048391207R00000X
MI390200000X
FLTRN41490207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program