Individual
MR. GABRIEL MANUEL CASANOVA JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
11200 SW 8TH ST, PHARMED ARENA 156, MIAMI, FL 33199-0001
(305) 348-1072
Mailing address
6990 NW 186TH ST APT 206, HIALEAH, FL 33015-3133
(305) 904-2704
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AL1460
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
AL1460
ATHLETIC TRAINER
FL
05
—
AL1460
—
FL
Enumeration date
05/01/2007
Last updated
07/09/2007
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