Provider Demographics
NPI:1679721393
Name:CANAVOSIO, FEDERICO MARIANO II (MEDICAL DOCTOR)
Entity Type:Individual
Prefix:DR
First Name:FEDERICO
Middle Name:MARIANO
Last Name:CANAVOSIO
Suffix:II
Gender:M
Credentials:MEDICAL DOCTOR
Other - Prefix:
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Mailing Address - Street 1:1300 36TH ST STE 1A
Mailing Address - Street 2:
Mailing Address - City:VERO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32960-4898
Mailing Address - Country:US
Mailing Address - Phone:772-925-8230
Mailing Address - Fax:772-925-8235
Practice Address - Street 1:1300 36TH ST STE 1A
Practice Address - Street 2:
Practice Address - City:VERO BEACH
Practice Address - State:FL
Practice Address - Zip Code:32960-4898
Practice Address - Country:US
Practice Address - Phone:772-925-8230
Practice Address - Fax:772-925-8235
Is Sole Proprietor?:No
Enumeration Date:2008-09-06
Last Update Date:2023-04-20
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FLME104488208M00000X, 207R00000X
COCDRH.0056925208M00000X
IN01081108A207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist