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Individual

DR. ANGEL LUIS CASANOVA NATER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
200 AVENUE F NE, EMERGENCY DEPT, WINTER HAVEN, FL 33881-4131
(863) 293-1121
Mailing address
PO BOX 44008, PROVIDER ENROLLMENT, JACKSONVILLE, FL 32231-4008
(904) 244-3660

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
M3960
TX
207P00000X
Emergency Medicine Physician
Primary
ME97079
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
277930700
FL
01
M3960
MEDICAL LIC
TX
01
ME97079
MEDICAL LIC
FL
Enumeration date
04/11/2006
Last updated
03/07/2023
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