Provider Demographics
NPI:1881678332
Name:CESAR LLANERA JR MD PA
Entity Type:Organization
Organization Name:CESAR LLANERA JR MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CESAR
Authorized Official - Middle Name:L
Authorized Official - Last Name:LLANERA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:850-477-5610
Mailing Address - Street 1:PO BOX 30027
Mailing Address - Street 2:
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32503-1027
Mailing Address - Country:US
Mailing Address - Phone:850-477-5610
Mailing Address - Fax:850-477-8319
Practice Address - Street 1:545 BRENT LN
Practice Address - Street 2:
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32503-2003
Practice Address - Country:US
Practice Address - Phone:850-477-5610
Practice Address - Fax:850-477-8319
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-30
Last Update Date:2019-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain MedicineGroup - Multi-Specialty
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Multi-Specialty
No208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL270913900Medicaid
AL529922550Medicaid
FLDE0446OtherMEDICARE RAILROAD
AL529922550Medicaid