MEDICARE: PAOLA CASANOVA MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	282N00000X	General Acute Care Hospital
2	207RC0000X	Cardiovascular Disease Physician	115874	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1053680496
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PAOLA CASANOVA MD

Provider Business Mailing Address
First Line	:	2900 CORPORATE WAY
Second Line	:	DOOR D
City	:	MIRAMAR
State	:	FL
Zip	:	33025-3925
Country	:	US
Telephone Number	:	954-276-5685
Fax Number	:	954-985-7074

Provider Business Practice Location Address
First Line	:	1951 SW 172ND AVE STE 404
Second Line	:
City	:	MIRAMAR
State	:	FL
Zip	:	33029-5614
Country	:	US
Telephone Number	:	954-265-7900
Fax Number	:	954-893-6361

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/14/2011
Last Update Date	:	03/15/2021

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Directions to “ PAOLA CASANOVA MD” Practice Location

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