Provider Demographics
NPI:1790780914
Name:CANAS, LUIS ROBERTO (MD)
Entity Type:Individual
Prefix:DR
First Name:LUIS
Middle Name:ROBERTO
Last Name:CANAS
Suffix:
Gender:M
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 2000
Mailing Address - Street 2:
Mailing Address - City:AIBONITO
Mailing Address - State:PR
Mailing Address - Zip Code:00705-2000
Mailing Address - Country:US
Mailing Address - Phone:787-638-0246
Mailing Address - Fax:787-735-2268
Practice Address - Street 1:5 CALLE GERONIMO MARTINEZ
Practice Address - Street 2:
Practice Address - City:AIBONITO
Practice Address - State:PR
Practice Address - Zip Code:00705-3660
Practice Address - Country:US
Practice Address - Phone:787-735-7859
Practice Address - Fax:787-954-7501
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-15
Last Update Date:2020-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR5047207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PRM0247OtherPLAN MENONITA
PR400012OtherMEDICARE Y MUCHO MAS
PR6090029OtherHUMANA
PR063965OtherLA CRUZ AZUL DE P.R.
PR26061OtherMEDICARE PTAN
PR26061OtherTRIPLE S
PRE08213Medicare UPIN