Organization
CASANOVA & CASANOVA MD'S PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LUIS A CASANOVA MD (PRESIDENT)
(941) 883-3313
Entity
Organization
Contact information
Practice address
3508 TAMIAMI TRL, SUITE C, PORT CHARLOTTE, FL 33952-8160
(941) 883-3313
(941) 883-3320
Mailing address
3508 TAMIAMI TRL, SUITE C, PORT CHARLOTTE, FL 33952-8160
(941) 883-3313
(941) 883-3320
Taxonomy
Speciality
Code
Description
License number
State
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
Primary
—
—
208000000X
Pediatrics Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
34749
BC/BS GROUP NUMBER
FL
Enumeration date
09/16/2005
Last updated
06/06/2011
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