Provider Demographics
NPI:1972685758
Name:CUBANO, CESAR M (MD)
Entity Type:Individual
Prefix:DR
First Name:CESAR
Middle Name:M
Last Name:CUBANO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2068
Mailing Address - Street 2:
Mailing Address - City:HATILLO
Mailing Address - State:PR
Mailing Address - Zip Code:00659-9068
Mailing Address - Country:US
Mailing Address - Phone:787-820-6842
Mailing Address - Fax:787-262-2468
Practice Address - Street 1:# 2 MARGINAL
Practice Address - Street 2:EDIF. TROPICAL PLAZA SUITE 3
Practice Address - City:HATILLO
Practice Address - State:PR
Practice Address - Zip Code:00659-9068
Practice Address - Country:US
Practice Address - Phone:787-820-6842
Practice Address - Fax:787-262-2468
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-20
Last Update Date:2014-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR109522084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR1858OtherMEDICARE Y MUCHO MAS
PR095892OtherPREF. MEDICARE CHOICE
PR8432OtherFIRST MEDICAL CARD
PR2184OtherHUMANA
PR87967OtherTRIPLE S
PR2184OtherHUMANA
PR8432OtherFIRST MEDICAL CARD
PR2184OtherHUMANA