Provider Demographics
NPI:1053680496
Name:CASANOVA, PAOLA (MD)
Entity Type:Individual
Prefix:
First Name:PAOLA
Middle Name:
Last Name:CASANOVA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2900 CORPORATE WAY
Mailing Address - Street 2:DOOR D
Mailing Address - City:MIRAMAR
Mailing Address - State:FL
Mailing Address - Zip Code:33025-3925
Mailing Address - Country:US
Mailing Address - Phone:954-276-5685
Mailing Address - Fax:954-985-7074
Practice Address - Street 1:1951 SW 172ND AVE STE 404
Practice Address - Street 2:
Practice Address - City:MIRAMAR
Practice Address - State:FL
Practice Address - Zip Code:33029-5614
Practice Address - Country:US
Practice Address - Phone:954-265-7900
Practice Address - Fax:954-893-6361
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-14
Last Update Date:2021-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
282N00000X
FL115874207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No282N00000XHospitalsGeneral Acute Care Hospital