Provider Demographics
NPI:1093033896
Name:PALOMEQUE, CESAR L (DMD)
Entity Type:Individual
Prefix:DR
First Name:CESAR
Middle Name:L
Last Name:PALOMEQUE
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1111 SW 8TH ST
Mailing Address - Street 2:SUITE 211
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33130-3639
Mailing Address - Country:US
Mailing Address - Phone:305-856-9837
Mailing Address - Fax:305-856-9180
Practice Address - Street 1:1111 SW 8TH ST
Practice Address - Street 2:SUITE 211
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33130-3639
Practice Address - Country:US
Practice Address - Phone:305-856-9837
Practice Address - Fax:305-856-9180
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-04
Last Update Date:2010-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN11333122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL072512900Medicaid