Provider Demographics
NPI:1215372743
Name:CANO EYE CLINIC
Entity Type:Organization
Organization Name:CANO EYE CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:ALAN
Authorized Official - Last Name:CANO
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:561-798-0903
Mailing Address - Street 1:9990 BELVEDERE RD
Mailing Address - Street 2:
Mailing Address - City:ROYAL PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33411-3518
Mailing Address - Country:US
Mailing Address - Phone:561-798-0903
Mailing Address - Fax:561-383-6938
Practice Address - Street 1:9990 BELVEDERE RD
Practice Address - Street 2:
Practice Address - City:ROYAL PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33411-3518
Practice Address - Country:US
Practice Address - Phone:561-798-0903
Practice Address - Fax:561-383-6938
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-10
Last Update Date:2013-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOPC3553152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLU78145Medicare UPIN