Healthcare Provider Details

I. General information

NPI: 1902133341
Provider Name (Legal Business Name): RENE CASANOVA MEDICAL OFFICE, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/05/2009
Last Update Date: 01/21/2026
Certification Date: 01/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1881 N UNIVERSITY DR STE 103
CORAL SPRINGS FL
33071-8923
US

IV. Provider business mailing address

1881 N UNIVERSITY DR STE 103
CORAL SPRINGS FL
33071-8923
US

V. Phone/Fax

Practice location:
  • Phone: 954-516-0070
  • Fax: 954-516-0029
Mailing address:
  • Phone: 954-516-0070
  • Fax: 954-516-0029

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number State

VIII. Authorized Official

Name: RENE CASANOVA
Title or Position: OWNER
Credential: MD
Phone: 954-516-0070