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Individual

DR. CESAR CORRETJER RUSSI

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1580 SANTA BARBARA BLVD, THE VILLAGES, FL 32159-6827
(352) 259-2159
(352) 259-5731
Mailing address
1580 SANTA BARBARA BLVD, THE VILLAGES, FL 32159-6827
(352) 259-2159
(352) 674-4386

Taxonomy

Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
16908
PR
208D00000X
General Practice Physician
Primary
ACN904
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
020454200
FL
01
IY786Z
MEDICARE PTAN
FL
01
W7PZB
BCBS
FL
Enumeration date
10/02/2007
Last updated
04/09/2018
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