Individual
SONIA IDALY CANO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
11601 MONTGOMERY BLVD NE, ALBUQUERQUE, NM 87111-2660
(505) 207-3421
(505) 702-8171
Mailing address
800 BRADBURY DR SE STE 116, ALBUQUERQUE, NM 87106-4310
(505) 272-1476
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA2023-0211
NM
363AM0700X
Medical Physician Assistant
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Other
Enumeration date
11/22/2021
Last updated
01/24/2025
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