Provider Demographics
NPI:1780217786
Name:CANO, JOSE
Entity Type:Individual
Prefix:MR
First Name:JOSE
Middle Name:
Last Name:CANO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17320 NW 46TH AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33055-3770
Mailing Address - Country:US
Mailing Address - Phone:786-454-6386
Mailing Address - Fax:
Practice Address - Street 1:15410 SW 284TH ST UNIT 105
Practice Address - Street 2:
Practice Address - City:HOMESTEAD
Practice Address - State:FL
Practice Address - Zip Code:33033-1313
Practice Address - Country:US
Practice Address - Phone:786-454-6386
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-02-18
Last Update Date:2020-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)