Provider Demographics
NPI:1023098084
Name:DETRES, CESAR A (MD)
Entity type:Individual
Prefix:
First Name:CESAR
Middle Name:A
Last Name:DETRES
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:PO BOX 6450 M
Mailing Address - Street 2:
Mailing Address - City:MAYAGUEZ
Mailing Address - State:PR
Mailing Address - Zip Code:00681-6450
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:CARR 349 KM 2.4 CERRO LAS MASAS
Practice Address - Street 2:HOSPITAL BELLA VISTA
Practice Address - City:MAYAGUEZ
Practice Address - State:PR
Practice Address - Zip Code:00680
Practice Address - Country:US
Practice Address - Phone:787-832-1585
Practice Address - Fax:787-883-2158
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-18
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PR3749207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
26657OtherSEGUROS DE SERVICIOS DE S
2458AOtherPREFERREED MEDICARE CHOIC
6605753521OtherMEDICAL CARD SYSTEMS INC
601074OtherMEDICARE Y MUCHO MAS
26657OtherMEDICARE OPTIMO
6605753521OtherMCS CLASSIC CARE
060051OtherLA CRUZ AZUL DE PUERTO RI
6605753521OtherMEDICAL CARD SYSTEMS HMO
060051OtherLA CRUZ AZUL DE PUERTO RI
26657OtherSEGUROS DE SERVICIOS DE S