MEDICARE: ROBERTO A CANO M.D.

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	174400000X	Specialist	ME55231	FL
2	207R00000X	Internal Medicine Physician	ME55231	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	:	1164488110
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROBERTO A CANO M.D.

Provider Business Mailing Address
First Line	:	3700 WASHINGTON ST
Second Line	:	SUITE 100
City	:	HOLLYWOOD
State	:	FL
Zip	:	33021-8256
Country	:	US
Telephone Number	:	954-983-6307
Fax Number	:	954-983-5809

Provider Business Practice Location Address
First Line	:	3700 WASHINGTON ST
Second Line	:	SUITE 100
City	:	HOLLYWOOD
State	:	FL
Zip	:	33021-8256
Country	:	US
Telephone Number	:	954-983-6307
Fax Number	:	954-983-5809

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

Provider Enumeration Date	:	04/26/2006
Last Update Date	:	01/13/2014

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