Provider Demographics
NPI:1295581411
Name:CESAR, KALANI JANELLE
Entity type:Individual
Prefix:PROF
First Name:KALANI
Middle Name:JANELLE
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 1:5447 TIMBERLEAF BLVD APT 304
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32811-2157
Mailing Address - Country:US
Mailing Address - Phone:321-512-3360
Mailing Address - Fax:
Practice Address - Street 1:1551 BOREN DR STE C
Practice Address - Street 2:
Practice Address - City:OCOEE
Practice Address - State:FL
Practice Address - Zip Code:34761-2966
Practice Address - Country:US
Practice Address - Phone:407-223-1298
Practice Address - Fax:407-395-8654
Is Sole Proprietor?:No
Enumeration Date:2024-04-29
Last Update Date:2024-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL976370106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician