Provider Demographics
NPI:1043542020
Name:PUMARIEGA, CESAR ANDRES (RPH)
Entity Type:Individual
Prefix:MR
First Name:CESAR
Middle Name:ANDRES
Last Name:PUMARIEGA
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11951 ELBERT ST
Mailing Address - Street 2:
Mailing Address - City:CLERMONT
Mailing Address - State:FL
Mailing Address - Zip Code:34711-7388
Mailing Address - Country:US
Mailing Address - Phone:352-242-5161
Mailing Address - Fax:
Practice Address - Street 1:11951 ELBERT ST
Practice Address - Street 2:
Practice Address - City:CLERMONT
Practice Address - State:FL
Practice Address - Zip Code:34711-7388
Practice Address - Country:US
Practice Address - Phone:352-242-5161
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-02
Last Update Date:2010-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS20162183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist