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General NPI Number Information
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NPI Number | 1902575632
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Entity Type | Individual
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Provider Name | ANTONIO CANERO PA-C
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Gender | Male
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Dates
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Enumeration Date | 09/07/2021
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Last Update Date | 12/02/2024
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Provider Practice Location Address
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Address Line | 4300 ALTON RD STE 2110
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City | MIAMI BEACH
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State | FL
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Zip | 33140-2948
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Country | US
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Telephone | 305-282-6840
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Fax |
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Provider Business Mailing Address
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Address Line | 14355 SW 78TH AVE
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City | PALMETTO BAY
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State | FL
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Zip | 33158-1505
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Country | US
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Telephone | 305-282-6840
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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 | 208G00000X
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Taxonomy Name | Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
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License Number | PA9115073
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License Number State | FL
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