Healthcare Provider Details

I. General information

NPI: 1902893167
Provider Name (Legal Business Name): YAMIL A CANAAN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/03/2005
Last Update Date: 04/27/2026
Certification Date: 04/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7971 SW 40TH ST STE 22
MIAMI FL
33155-6749
US

IV. Provider business mailing address

7971 SW 40TH ST STE 22
MIAMI FL
33155-6749
US

V. Phone/Fax

Practice location:
  • Phone: 786-655-6566
  • Fax: 305-294-2678
Mailing address:
  • Phone: 786-655-6566
  • Fax: 305-294-2678

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number83652
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number83880
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: