Provider Demographics
NPI:1396887196
Name:VIANA, CESAR (MD)
Entity type:Individual
Prefix:
First Name:CESAR
Middle Name:
Last Name:VIANA
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:B1 CALLE SAN MATEO
Mailing Address - Street 2:URB.SAN PEDRO
Mailing Address - City:TOA BAJA
Mailing Address - State:PR
Mailing Address - Zip Code:00949-5406
Mailing Address - Country:US
Mailing Address - Phone:787-251-1969
Mailing Address - Fax:787-798-4118
Practice Address - Street 1:KM1.5 CALLE 863
Practice Address - Street 2:PAJAROS
Practice Address - City:TOA BAJA
Practice Address - State:PR
Practice Address - Zip Code:00949-5406
Practice Address - Country:US
Practice Address - Phone:787-798-4118
Practice Address - Fax:787-798-4118
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-12
Last Update Date:2015-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR06795208000000X, 208D00000X
261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR9-8939 VIOtherTRIPLE S
PR6795OtherCOSVI
PR6795OtherCIGNA
PR6795OtherPALIC
PR6795OtherMAPFRE
PR068875OtherCRUZ AZUL