Individual
MARIO I CANEDO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3000 MEDICAL PARK DR STE 300, TAMPA, FL 33613
(813) 615-8088
(813) 615-8468
Mailing address
3000 MEDICAL PARK DR STE 300, TAMPA, FL 33613-4696
(813) 615-8088
(813) 615-8468
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
ME38331
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00657
UNIVERSAL
FL
01
—
060009578
RAILROAD MEDICARE
FL
05
—
069603000
—
FL
01
—
211423
AVMED
FL
01
—
4084384
AETNA
FL
01
—
592998397C
HUMANA
FL
Enumeration date
11/27/2006
Last updated
02/21/2019
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