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NPI Code Detail

MEDICARE: CANO HEALTH NEVADA PLLC

MEDICARE: CANO HEALTH NEVADA PLLC
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
1208D00000XGeneral Practice Physician

General Provider Information

NPI Number : 1265196893
Entity Type Code : Organization
Provider Name (Legal Business Name) : CANO HEALTH NEVADA PLLC
Provider Business Mailing Address
First Line : 9725 NW 117TH AVE STE 200
Second Line :
City : MEDLEY
State : FL
Zip : 33178-1260
Country : US
Telephone Number : 954-514-9360
Fax Number :
Provider Business Practice Location Address
First Line : 2335 E LAKE MEAD BLVD
Second Line :
City : NORTH LAS VEGAS
State : NV
Zip : 89030-7141
Country : US
Telephone Number : 855-226-6633
Fax Number :
Authorized Official
Title or Position : CEO
Name : DR. MARLOW BLAS HERNANDEZ
Credential : DO
Telephone Number : 954-514-9360
Provider Enumeration Date : 10/29/2021
Last Update Date : 10/29/2021

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Directions to “CANO HEALTH NEVADA PLLC ” Practice Location

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