Provider Demographics
NPI:1174525778
Name:CANO, ANTONIO C (MD)
Entity type:Individual
Prefix:
First Name:ANTONIO
Middle Name:C
Last Name:CANO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:8726 NW 26TH ST
Mailing Address - Street 2:STE 5
Mailing Address - City:DORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33172-1628
Mailing Address - Country:US
Mailing Address - Phone:305-456-7636
Mailing Address - Fax:305-468-6363
Practice Address - Street 1:8726 NW 26TH ST
Practice Address - Street 2:STE 5
Practice Address - City:DORAL
Practice Address - State:FL
Practice Address - Zip Code:33172-1628
Practice Address - Country:US
Practice Address - Phone:305-456-7636
Practice Address - Fax:305-468-6363
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-12
Last Update Date:2019-06-12
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME92396207RI0011X, 207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLME92396OtherSTATE LICENSE
FL274934300Medicaid
FLI47540Medicare UPIN
FL274934300Medicaid