Provider Demographics
NPI:1568122489
Name:CANIZARES, MYRA (APRN)
Entity Type:Individual
Prefix:
First Name:MYRA
Middle Name:
Last Name:CANIZARES
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12350 NW 39TH ST STE 200
Mailing Address - Street 2:
Mailing Address - City:CORAL SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33065-2414
Mailing Address - Country:US
Mailing Address - Phone:954-248-3422
Mailing Address - Fax:800-970-6020
Practice Address - Street 1:815 CORAL RIDGE DR
Practice Address - Street 2:
Practice Address - City:CORAL SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33071-4180
Practice Address - Country:US
Practice Address - Phone:954-248-3422
Practice Address - Fax:800-970-6020
Is Sole Proprietor?:No
Enumeration Date:2021-12-20
Last Update Date:2024-02-29
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLAPRN11010058363LF0000X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner