Individual
ANTONIO CANAAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1220 WILLIS AVE, DAYTONA BEACH, FL 32114-2810
(386) 236-3200
(386) 236-3161
Mailing address
1220 WILLIS AVE, DAYTONA BEACH, FL 32114-2810
(386) 236-3200
(386) 236-3161
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
ME60487
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
056828700
—
FL
01
—
14325
BCBS
FL
Enumeration date
12/05/2006
Last updated
09/17/2009
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