MEDICARE: ORESTES FERNANDEZ CANO MD PA

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	208600000X	Surgery Physician	ME 14403	FL

General Provider Information

NPI Number	:	1568407864
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ORESTES FERNANDEZ CANO MD PA

Provider Business Mailing Address
First Line	:	3230 SW 79TH AVE
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33155-3408
Country	:	US
Telephone Number	:	305-904-0000
Fax Number	:	305-661-7086

Provider Business Practice Location Address
First Line	:	3934 SW 8TH ST
Second Line	:	SUITE 308
City	:	CORAL GABLES
State	:	FL
Zip	:	33134-2949
Country	:	US
Telephone Number	:	305-447-4009
Fax Number	:	305-447-4085

Authorized Official
Title or Position	:	OWNER
Name	:	ORESTES FERNANDEZ
Credential	:	M.D.
Telephone Number	:	305-904-0000

Provider Enumeration Date	:	06/19/2006
Last Update Date	:	07/10/2007

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