Healthcare Provider Details

I. General information

NPI: 1033680228
Provider Name (Legal Business Name): JORGE L CASIANO DEL TORO CRNA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/16/2018
Last Update Date: 12/16/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7500 SW 87TH AVE STE 101
MIAMI FL
33173-5426
US

IV. Provider business mailing address

9500 S DADELAND BLVD STE 200
MIAMI FL
33156-2866
US

V. Phone/Fax

Practice location:
  • Phone: 305-913-0666
  • Fax:
Mailing address:
  • Phone: 305-468-4185
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberAPRN9488816
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: