Provider Demographics
NPI:1184006488
Name:CASANOVA, TERESA
Entity Type:Individual
Prefix:
First Name:TERESA
Middle Name:
Last Name:CASANOVA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3700 CURRY FORD RD
Mailing Address - Street 2:APT. M4
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32806-2677
Mailing Address - Country:US
Mailing Address - Phone:787-345-1344
Mailing Address - Fax:
Practice Address - Street 1:3700 CURRY FORD RD
Practice Address - Street 2:APT. M4
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32806-2677
Practice Address - Country:US
Practice Address - Phone:787-345-1344
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-06-23
Last Update Date:2015-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator