Provider Demographics
NPI:1225724032
Name:CANTON, ANALEX (FNP)
Entity Type:Individual
Prefix:
First Name:ANALEX
Middle Name:
Last Name:CANTON
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1035 W 77TH ST APT 301
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33014-3975
Mailing Address - Country:US
Mailing Address - Phone:305-343-8109
Mailing Address - Fax:
Practice Address - Street 1:1035 W 77TH ST APT 301
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33014-3975
Practice Address - Country:US
Practice Address - Phone:305-343-8109
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-14
Last Update Date:2023-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL3030072163WC0200X
FL11025802207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No163WC0200XNursing Service ProvidersRegistered NurseCritical Care Medicine