MEDICARE: RENE CASANOVA MEDICAL OFFICE, INC

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	208D00000X	General Practice Physician

General Provider Information

NPI Number	:	1902133341
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RENE CASANOVA MEDICAL OFFICE, INC

Provider Business Mailing Address
First Line	:	1881 N UNIVERSITY DR STE 103
Second Line	:
City	:	CORAL SPRINGS
State	:	FL
Zip	:	33071-8923
Country	:	US
Telephone Number	:	954-516-0070
Fax Number	:	954-516-0029

Provider Business Practice Location Address
First Line	:	1881 N UNIVERSITY DR STE 103
Second Line	:
City	:	CORAL SPRINGS
State	:	FL
Zip	:	33071-8923
Country	:	US
Telephone Number	:	954-516-0070
Fax Number	:	954-516-0029

Authorized Official
Title or Position	:	OWNER
Name	:	RENE CASANOVA
Credential	:	MD
Telephone Number	:	954-516-0070

Provider Enumeration Date	:	11/05/2009
Last Update Date	:	01/21/2026

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