Healthcare Provider Details

I. General information

NPI: 1497679500
Provider Name (Legal Business Name): ANTONIA CANO L.AC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/10/2026
Last Update Date: 08/10/2026
Certification Date: 08/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2200 BISCAYNE BLVD
MIAMI FL
33137-5283
US

IV. Provider business mailing address

7974 NW 116TH AVE
DORAL FL
33178-2532
US

V. Phone/Fax

Practice location:
  • Phone: 305-209-3886
  • Fax:
Mailing address:
  • Phone: 786-493-6250
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberAP4779
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: