Provider Demographics
NPI:1295789618
Name:JARA, CESAR ANTONIO (MD)
Entity type:Individual
Prefix:DR
First Name:CESAR
Middle Name:ANTONIO
Last Name:JARA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2100 OCOEE APOPKA RD STE 120
Mailing Address - Street 2:
Mailing Address - City:APOPKA
Mailing Address - State:FL
Mailing Address - Zip Code:32703-9210
Mailing Address - Country:US
Mailing Address - Phone:407-889-1930
Mailing Address - Fax:407-889-1904
Practice Address - Street 1:2100 OCOEE APOPKA RD STE 120
Practice Address - Street 2:
Practice Address - City:APOPKA
Practice Address - State:FL
Practice Address - Zip Code:32703-9210
Practice Address - Country:US
Practice Address - Phone:407-889-1930
Practice Address - Fax:407-889-1904
Is Sole Proprietor?:No
Enumeration Date:2006-05-20
Last Update Date:2025-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI70837-20207RI0011X
FLME68750207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL251314500Medicaid
WI1295789618Medicaid
P00370634OtherRAIL ROAD MEDICARE
FLH24080Medicare UPIN
FL251314500Medicaid