HUMBERTO CASANOVA MD PA
Ambulatory Health at 78 Ave, Hialeah, FL

License number
Florida ME83737
Category
Ambulatory Health
Type
Primary Care
Owner
Name: DR. HUMBERTO CASANOVA MD
Title: MD
Phone: (305) 827-3388
Address
Address
17670 NW 78Th Ave SUITE 109, Hialeah, FL 33015
National Provider ID: 1841606100
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

See more information about HUMBERTO CASANOVA MD PA at bizstanding.com

HUMBERTO CASANOVA M.D. PA

Hialeah, FL

Status:
Inactive
Industry:
Medical Doctor's Office
Inactive reason:
CANCEL ADM DISS/REV
Registration:
Sep 19, 2005
Inactive since:
Oct 6, 2006
Addresses:
17670 NW 78 Ave 109, Hialeah, FL 33015 (Physical)
17670 NW 78 Ave, Hialeah, FL 33015
7856 NW 178 St, Hialeah, FL 33015
State ID:
P05000129141
Business type:
Florida Profit Corporation
Secretary, Vice Presidents:
Humberto Casanova (President, Director), 17670 NW 78 Ave SUITE 109, Hialeah, FL 33015 (Physical),Teresa D. Casanova Secretary, Vice President, inactive
EIN:
203505561

Ambulatory Health licenses in Florida










Other Doctors licenses in Florida