Healthcare Provider Details

I. General information

NPI: 1992621759
Provider Name (Legal Business Name): LOURDES CANO APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/25/2026
Last Update Date: 06/25/2026
Certification Date: 06/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

301 SW 66TH AVE
MIAMI FL
33144-2927
US

IV. Provider business mailing address

301 SW 66TH AVE
MIAMI FL
33144-2927
US

V. Phone/Fax

Practice location:
  • Phone: 786-499-2610
  • Fax:
Mailing address:
  • Phone: 786-499-2610
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number11047206
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: