Provider Demographics
NPI:1982902904
Name:CESAR, TERICKA SMITH (ANP)
Entity Type:Individual
Prefix:MRS
First Name:TERICKA
Middle Name:SMITH
Last Name:CESAR
Suffix:
Gender:F
Credentials:ANP
Other - Prefix:MRS
Other - First Name:TERI
Other - Middle Name:SMITH
Other - Last Name:CESAR
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:ANP
Mailing Address - Street 1:3550 NW 194TH TER
Mailing Address - Street 2:
Mailing Address - City:MIAMI GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33056-2230
Mailing Address - Country:US
Mailing Address - Phone:615-509-5733
Mailing Address - Fax:
Practice Address - Street 1:3550 NW 194TH TER
Practice Address - Street 2:
Practice Address - City:MIAMI GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33056-2230
Practice Address - Country:US
Practice Address - Phone:615-509-5733
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-03-01
Last Update Date:2016-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN15594363LA2200X
FL9320003363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health