Provider Demographics
NPI:1407417587
Name:PROANO, ANA CAROLINA (MD)
Entity Type:Individual
Prefix:
First Name:ANA
Middle Name:CAROLINA
Last Name:PROANO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 919771
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32891-0001
Mailing Address - Country:US
Mailing Address - Phone:239-278-3600
Mailing Address - Fax:239-479-5202
Practice Address - Street 1:4300 KINGS HWY STE 500
Practice Address - Street 2:
Practice Address - City:PORT CHARLOTTE
Practice Address - State:FL
Practice Address - Zip Code:33980-2953
Practice Address - Country:US
Practice Address - Phone:239-344-2325
Practice Address - Fax:941-764-6176
Is Sole Proprietor?:No
Enumeration Date:2019-06-27
Last Update Date:2022-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
FLME154410208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program