Provider Demographics
NPI:1366066649
Name:CANAS, IVAN DARIO JR (DNP)
Entity type:Individual
Prefix:DR
First Name:IVAN
Middle Name:DARIO
Last Name:CANAS
Suffix:JR
Gender:M
Credentials:DNP
Other - Prefix:
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Mailing Address - Street 1:8260 W FLAGLER ST STE 2I
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33144-2069
Mailing Address - Country:US
Mailing Address - Phone:786-715-9183
Mailing Address - Fax:
Practice Address - Street 1:8260 W FLAGLER ST STE 2I
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33144-2069
Practice Address - Country:US
Practice Address - Phone:786-715-9183
Practice Address - Fax:786-713-1115
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-03
Last Update Date:2022-01-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FL11007345363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily