Provider Demographics
NPI:1972987147
Name:CARDENAS, JULIO CESAR
Entity Type:Individual
Prefix:
First Name:JULIO
Middle Name:CESAR
Last Name:CARDENAS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8882 W FLAGLER ST APT 204
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33174-3953
Mailing Address - Country:US
Mailing Address - Phone:786-444-9324
Mailing Address - Fax:
Practice Address - Street 1:8882 W FLAGLER ST APT 204
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33174-3953
Practice Address - Country:US
Practice Address - Phone:786-444-9324
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-16
Last Update Date:2015-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9333042363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily