Healthcare Provider Details

I. General information

NPI: 1700526381
Provider Name (Legal Business Name): CANO HEALTH, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/31/2022
Last Update Date: 05/20/2025
Certification Date: 05/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

368 E DANIA BEACH BLVD
DANIA FL
33004-3020
US

IV. Provider business mailing address

9725 NW 117TH AVE STE 200
MEDLEY FL
33178-1260
US

V. Phone/Fax

Practice location:
  • Phone: 855-226-6633
  • Fax:
Mailing address:
  • Phone: 954-514-9360
  • Fax:

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: JOHN LINES
Title or Position: CLO
Credential:
Phone: 954-408-8672