Individual
DR. JUAN R CANIZALES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2129
NC
152W00000X
Optometrist
740
HI
152W00000X
Optometrist
OPC4007
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P00369116
RAIL ROAD MEDICARE
FL
Enumeration date
10/20/2005
Last updated
07/22/2013
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