Provider Demographics
NPI:1639381247
Name:ANTONIO CANO PLLC
Entity Type:Organization
Organization Name:ANTONIO CANO PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ANTONIO
Authorized Official - Middle Name:
Authorized Official - Last Name:CANO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:305-807-1049
Mailing Address - Street 1:PO BOX 402585
Mailing Address - Street 2:
Mailing Address - City:MIAMI BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33140-0585
Mailing Address - Country:US
Mailing Address - Phone:305-807-1049
Mailing Address - Fax:305-447-9470
Practice Address - Street 1:5005 COLLINS AVE
Practice Address - Street 2:STE 1516
Practice Address - City:MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33140-2753
Practice Address - Country:US
Practice Address - Phone:305-807-1049
Practice Address - Fax:305-447-9470
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-04
Last Update Date:2007-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME92396207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLME92396OtherSTATE MEDICAL LICENSE