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General NPI Number Information
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NPI Number | 1376083972
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Entity Type | Organization
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Legal Business Name | PAOLA CASANOVA, MD, PLLC
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Dates
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Enumeration Date | 03/01/2017
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Last Update Date | 03/01/2017
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Provider Practice Location Address
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Address Line | 3145 NE 184TH ST APT 5303
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City | AVENTURA
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State | FL
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Zip | 33160-2467
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Country | US
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Telephone | 954-909-7979
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Fax | 305-357-3683
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Provider Business Mailing Address
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Address Line | 3145 NE 184TH ST APT 5303
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City | AVENTURA
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State | FL
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Zip | 33160-2467
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Country | US
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Telephone | 954-909-7979
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Fax | 305-357-3683
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Authorized Official
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Title or Position | MANAGER
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Name | DR. PAOLA CASANOVA
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Credential | MD
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Telephone | 561-951-6884
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number | ME115874
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License Number State | FL
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