Provider Demographics
NPI:1902133341
Name:RENE CASANOVA MEDICAL OFFICE INC
Entity Type:Organization
Organization Name:RENE CASANOVA MEDICAL OFFICE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RENE
Authorized Official - Middle Name:
Authorized Official - Last Name:CASANOVA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:305-554-5627
Mailing Address - Street 1:1881 N UNIVERSITY DR STE 103
Mailing Address - Street 2:
Mailing Address - City:CORAL SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33071-8923
Mailing Address - Country:US
Mailing Address - Phone:305-554-5627
Mailing Address - Fax:954-336-7958
Practice Address - Street 1:1655 E OAKLAND PARK BLVD
Practice Address - Street 2:
Practice Address - City:OAKLAND PARK
Practice Address - State:FL
Practice Address - Zip Code:33334-5236
Practice Address - Country:US
Practice Address - Phone:305-554-5627
Practice Address - Fax:954-336-7958
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-11-05
Last Update Date:2023-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty