Basic Information
| Provider Information | |||||||||
| NPI: | 1689901688 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | CANO HEALTH, LLC | ||||||||
| LastName: | |||||||||
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| OtherOrganizationName: | CANO HEALTH, COMFORT HEALTH, COMFORT HEALTH MEDICAL CENTER | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 9725 NW 117TH AVE FL 2 | ||||||||
| Address2: | |||||||||
| City: | MEDLEY | ||||||||
| State: | FL | ||||||||
| PostalCode: | 331781212 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9545149360 | ||||||||
| FaxNumber: | 9544325060 | ||||||||
| Practice Location | |||||||||
| Address1: | 680 N UNIVERSITY DRIVE | ||||||||
| Address2: | |||||||||
| City: | PEMBROKE PINES | ||||||||
| State: | FL | ||||||||
| PostalCode: | 33024 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9545386868 | ||||||||
| FaxNumber: | 9545386850 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/11/2009 | ||||||||
| LastUpdateDate: | 11/12/2021 | ||||||||
| NPIDeactivationReasonCode: | |||||||||
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| ProviderGenderCode: | |||||||||
| AuthorizedOfficialLastName: | HERNANDEZ | ||||||||
| AuthorizedOfficialFirstName: | MARLOW | ||||||||
| AuthorizedOfficialMiddleName: | B | ||||||||
| AuthorizedOfficialTitleorPosition: | C.E.O. | ||||||||
| AuthorizedOfficialTelephone: | 9545149360 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
| ParentOrganizationLBN: | |||||||||
| AuthorizedOfficialNamePrefix: | DR. | ||||||||
| AuthorizedOfficialNameSuffix: | |||||||||
| AuthorizedOfficialCredential: | D.O.,M.P.H.,M.B.A. | ||||||||
| NPICertificationDate: | 11/12/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208D00000X | OS11834 | FL | N | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | General Practice | 208D00000X | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | General Practice |
No ID Information.