MEDICARE: CANO HEALTH, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208D00000X	General Practice Physician

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1356123129
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CANO HEALTH, LLC

Provider Business Mailing Address
First Line	:	8333 NW 53RD ST FL 6
Second Line	:
City	:	DORAL
State	:	FL
Zip	:	33166-4783
Country	:	US
Telephone Number	:	954-408-8672
Fax Number	:	954-901-2654

Provider Business Practice Location Address
First Line	:	470 MALABAR RD SE UNIT 101
Second Line	:
City	:	PALM BAY
State	:	FL
Zip	:	32907-3124
Country	:	US
Telephone Number	:	321-733-2966
Fax Number	:

Authorized Official
Title or Position	:	CLO
Name	:	JOHN LINES
Credential	:
Telephone Number	:	954-408-8672

Provider Enumeration Date	:	10/17/2023
Last Update Date	:	05/20/2026

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Directions to “CANO HEALTH, LLC ” Practice Location

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