Provider Demographics
NPI:1568969061
Name:PENARANDA, CESAR POMPERADA JR (ARNP-FNP-BC)
Entity Type:Individual
Prefix:MR
First Name:CESAR
Middle Name:POMPERADA
Last Name:PENARANDA
Suffix:JR
Gender:M
Credentials:ARNP-FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1236 ROSEGATE BLVD
Mailing Address - Street 2:
Mailing Address - City:RIVIERA BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33404-1822
Mailing Address - Country:US
Mailing Address - Phone:561-842-2953
Mailing Address - Fax:561-863-2846
Practice Address - Street 1:1236 ROSEGATE BLVD
Practice Address - Street 2:
Practice Address - City:RIVIERA BEACH
Practice Address - State:FL
Practice Address - Zip Code:33404-1822
Practice Address - Country:US
Practice Address - Phone:561-842-2953
Practice Address - Fax:561-863-2846
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-11
Last Update Date:2018-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9177445363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily