MEDICARE: MISS ELIZABETH CANO RN

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	171M00000X	Case Manager/Care Coordinator	767811	TX

General Provider Information

NPI Number	:	1598309130
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MISS ELIZABETH CANO RN

Provider Business Mailing Address
First Line	:	7019 W VILLAGE BLVD STE 205
Second Line	:
City	:	LAREDO
State	:	TX
Zip	:	78041-2297
Country	:	US
Telephone Number	:	956-712-4700
Fax Number	:	956-712-4646

Provider Business Practice Location Address
First Line	:	7019 W VILLAGE BLVD STE 205
Second Line	:
City	:	LAREDO
State	:	TX
Zip	:	78041-2297
Country	:	US
Telephone Number	:	956-712-4700
Fax Number	:	956-712-4646

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

Provider Enumeration Date	:	11/06/2019
Last Update Date	:	11/06/2019

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