Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QA0505X | Family Doctor - Adult Medicine | ME49934 | FL |
NPI | 1205868718 |
---|---|
Provider Name | Mr. Cesar Nabong Abiera JR. |
First Address | Deland, FL 32720-7005 |
Second Address | Deland, FL 32720-7005 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 07/07/2006 |
Last Update Date | 08/07/2007 |