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General NPI Number Information
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NPI Number | 1487792461
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Entity Type | Individual
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Provider Name | WILFREDO CANALES
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Gender | Male
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Dates
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Enumeration Date | 02/02/2007
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Last Update Date | 07/30/2025
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Provider Practice Location Address
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Address Line | 1414 NW 107TH AVE STE 101
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City | SWEETWATER
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State | FL
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Zip | 33172-2739
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Country | US
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Telephone | 305-640-8675
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Fax | 305-414-2990
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Provider Business Mailing Address
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Address Line | 1301 NE MIAMI GARDENS DR APT 1525
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City | MIAMI GARDENS
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State | FL
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Zip | 33179-4994
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Country | US
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Telephone | 305-333-0879
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PT17474
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License Number State | FL
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