Provider Demographics
NPI:1134485832
Name:CANIZARES ROSARIO, ORLANDO (MD)
Entity Type:Individual
Prefix:
First Name:ORLANDO
Middle Name:
Last Name:CANIZARES ROSARIO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:ORLANDO
Other - Middle Name:
Other - Last Name:CANIZARES
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:300 AVE LA SIERRA
Mailing Address - Street 2:BOX 18
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00926-4330
Mailing Address - Country:US
Mailing Address - Phone:787-949-5027
Mailing Address - Fax:
Practice Address - Street 1:400 AVE FD ROOSEVELT
Practice Address - Street 2:SUITE 412
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00918-2103
Practice Address - Country:US
Practice Address - Phone:787-949-5027
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-06
Last Update Date:2015-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR188812086S0122X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive Surgery