Healthcare Provider Details
I. General information
NPI: 1912287343
Provider Name (Legal Business Name): ORESTES ENRIQUE CANIZARES RENSOLI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 08/16/2011
Last Update Date: 07/22/2025
Certification Date: 07/22/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
151 SW 27TH AVE
MIAMI FL
33135-1428
US
IV. Provider business mailing address
8600 NW 41ST ST
DORAL FL
33166-6202
US
V. Phone/Fax
- Phone: 305-642-5366
- Fax: 305-644-6407
- Phone: 305-642-5366
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 282N00000X |
| Taxonomy | General Acute Care Hospital |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207R00000X |
| Taxonomy | Internal Medicine Physician |
| License Number | ME120458 |
| License Number State | FL |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: