Provider Demographics
NPI:1811421027
Name:CASANOVA, MARCO ALEJANDRO (DO)
Entity Type:Individual
Prefix:DR
First Name:MARCO
Middle Name:ALEJANDRO
Last Name:CASANOVA
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:8200 SW 117TH AVE STE 304
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33183-4826
Mailing Address - Country:US
Mailing Address - Phone:305-226-5651
Mailing Address - Fax:305-226-2424
Practice Address - Street 1:8200 SW 117TH AVE STE 304
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33183-4826
Practice Address - Country:US
Practice Address - Phone:305-226-5651
Practice Address - Fax:305-226-2424
Is Sole Proprietor?:No
Enumeration Date:2017-04-13
Last Update Date:2022-01-13
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLOS18470207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology