Provider Demographics
NPI:1396376190
Name:NCANCIOMORALESMDPA
Entity Type:Organization
Organization Name:NCANCIOMORALESMDPA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:NESTOR
Authorized Official - Middle Name:
Authorized Official - Last Name:CANCIO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-281-7063
Mailing Address - Street 1:3661 S MIAMI AVE STE 402
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33133-4230
Mailing Address - Country:US
Mailing Address - Phone:305-281-7063
Mailing Address - Fax:347-493-4312
Practice Address - Street 1:3661 S MIAMI AVE STE 402
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33133-4230
Practice Address - Country:US
Practice Address - Phone:305-281-7063
Practice Address - Fax:347-493-4312
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-01-30
Last Update Date:2020-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2278P1004XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, CertifiedPulmonary DiagnosticsGroup - Single Specialty