Provider Demographics
NPI:1710614292
Name:CESAR, ROSE BRIGITTE
Entity Type:Individual
Prefix:
First Name:ROSE
Middle Name:BRIGITTE
Last Name:CESAR
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2533 SE OAKLYN ST
Mailing Address - Street 2:
Mailing Address - City:PORT ST LUCIE
Mailing Address - State:FL
Mailing Address - Zip Code:34984-5227
Mailing Address - Country:US
Mailing Address - Phone:610-507-0203
Mailing Address - Fax:
Practice Address - Street 1:2533 SE OAKLYN ST
Practice Address - Street 2:
Practice Address - City:PORT ST LUCIE
Practice Address - State:FL
Practice Address - Zip Code:34984-5227
Practice Address - Country:US
Practice Address - Phone:610-507-0203
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-04
Last Update Date:2022-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician