Provider Demographics
NPI:1598088668
Name:BONILLA ISAZA, CESAR AUGUSTO (MD)
Entity type:Individual
Prefix:DR
First Name:CESAR
Middle Name:AUGUSTO
Last Name:BONILLA ISAZA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2100 OCOEE APOPKA RD STE 120
Mailing Address - Street 2:
Mailing Address - City:APOPKA
Mailing Address - State:FL
Mailing Address - Zip Code:32703-9210
Mailing Address - Country:US
Mailing Address - Phone:407-889-1930
Mailing Address - Fax:407-889-1904
Practice Address - Street 1:2100 OCOEE APOPKA RD STE 120
Practice Address - Street 2:
Practice Address - City:APOPKA
Practice Address - State:FL
Practice Address - Zip Code:32703
Practice Address - Country:US
Practice Address - Phone:407-889-1930
Practice Address - Fax:407-889-1904
Is Sole Proprietor?:No
Enumeration Date:2010-03-03
Last Update Date:2018-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLTRN 10932207R00000X
FLME115223207RC0001X
FLME 115223207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RC0001XAllopathic & Osteopathic PhysiciansInternal MedicineClinical Cardiac Electrophysiology