Healthcare Provider Details

I. General information

NPI: 1851300701
Provider Name (Legal Business Name): ORLANDO CANIZARES M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/07/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 ROOSEVELT AVE. CLINICA LAS AMERICAS SUITE 412
SAN JUAN PR
00918
US

IV. Provider business mailing address

AVE. ROOSEVELT # 400 SUITE 412- CLINICA LAS AMERICAS
SAN JUAN PR
00918
US

V. Phone/Fax

Practice location:
  • Phone: 787-753-1999
  • Fax: 787-753-1101
Mailing address:
  • Phone: 787-753-1999
  • Fax: 787-753-1101

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code173000000X
TaxonomyLegal Medicine
License Number4921
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: