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General NPI Number Information
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NPI Number | 1538154497
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Entity Type | Organization
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Legal Business Name | CASANOVA & CASANOVA MD'S PA
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Dates
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Enumeration Date | 09/16/2005
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Last Update Date | 06/06/2011
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Provider Practice Location Address
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Address Line | 3508 TAMIAMI TRL SUITE C
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City | PORT CHARLOTTE
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State | FL
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Zip | 33952-8160
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Country | US
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Telephone | 941-883-3313
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Fax | 941-883-3320
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Provider Business Mailing Address
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Address Line | 3508 TAMIAMI TRL SUITE C
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City | PORT CHARLOTTE
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State | FL
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Zip | 33952-8160
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Country | US
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Telephone | 941-883-3313
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Fax | 941-883-3320
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Authorized Official
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Title or Position | PRESIDENT
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Name | LUIS A CASANOVA
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Credential | MD
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Telephone | 941-883-3313
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207RG0300X
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Taxonomy Name | Geriatric Medicine (Internal Medicine) Physician
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License Number |
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License Number State |
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