Provider Demographics
NPI:1982735320
Name:CUARESMA, CERENA (CRNFA)
Entity Type:Individual
Prefix:
First Name:CERENA
Middle Name:
Last Name:CUARESMA
Suffix:
Gender:F
Credentials:CRNFA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10190 SW 3RD ST
Mailing Address - Street 2:
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33324-2234
Mailing Address - Country:US
Mailing Address - Phone:954-382-2930
Mailing Address - Fax:954-382-4910
Practice Address - Street 1:1367 S UNIVERSITY DR
Practice Address - Street 2:
Practice Address - City:PLANTATION
Practice Address - State:FL
Practice Address - Zip Code:33324-4000
Practice Address - Country:US
Practice Address - Phone:954-382-2930
Practice Address - Fax:954-382-4910
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN959512163WR0006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WR0006XNursing Service ProvidersRegistered NurseRegistered Nurse First Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLY9615OtherBLUE CROSS BLUE SHIELD