Provider Demographics
NPI:1588651830
Name:CESAIRE, ABNER (RPH)
Entity Type:Individual
Prefix:
First Name:ABNER
Middle Name:
Last Name:CESAIRE
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 1:5550 NW 44TH ST
Mailing Address - Street 2:APT B504
Mailing Address - City:LAUDERHILL
Mailing Address - State:FL
Mailing Address - Zip Code:33319-6187
Mailing Address - Country:US
Mailing Address - Phone:954-253-7502
Mailing Address - Fax:954-253-7502
Practice Address - Street 1:5550 NW 44TH ST
Practice Address - Street 2:APT B504
Practice Address - City:LAUDERHILL
Practice Address - State:FL
Practice Address - Zip Code:33319-6187
Practice Address - Country:US
Practice Address - Phone:954-253-7502
Practice Address - Fax:954-253-7502
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-03
Last Update Date:2012-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS 30149183500000X
FLPU 4704183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLPS 30149OtherPHARMACIST LICENSE
FLPU 4704OtherCONSULTANT PHARMACIST LIC