Provider Demographics
NPI:1174517676
Name:EURIBE, CESAR A (MD)
Entity type:Individual
Prefix:
First Name:CESAR
Middle Name:A
Last Name:EURIBE
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 1:2419 SE 22ND PL
Mailing Address - Street 2:
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34471-8222
Mailing Address - Country:US
Mailing Address - Phone:352-572-9760
Mailing Address - Fax:
Practice Address - Street 1:2419 SE 22ND PL
Practice Address - Street 2:
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34471-8222
Practice Address - Country:US
Practice Address - Phone:352-572-9760
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-09-12
Last Update Date:2019-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME45785208VP0014X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL42188OtherBLUE SHIELD PROV #
FL041743200Medicaid
FL42188QMedicare PIN
FL42188BMedicare PIN
FL42188PMedicare PIN
FL50079927Medicare PIN
FL42188OtherBLUE SHIELD PROV #
FL041743200Medicaid