Provider Demographics
NPI:1386693901
Name:CANINO, MIGUEL A (MD)
Entity type:Individual
Prefix:
First Name:MIGUEL
Middle Name:A
Last Name:CANINO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5508 SW 8TH ST
Mailing Address - Street 2:
Mailing Address - City:CORAL GABLES
Mailing Address - State:FL
Mailing Address - Zip Code:33134-2220
Mailing Address - Country:US
Mailing Address - Phone:305-476-1414
Mailing Address - Fax:305-476-1336
Practice Address - Street 1:5508 SW 8TH ST
Practice Address - Street 2:
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33134-2220
Practice Address - Country:US
Practice Address - Phone:305-476-1414
Practice Address - Fax:305-476-1336
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0029493207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
D66012Medicare UPIN
FL92766YMedicare ID - Type UnspecifiedPARTB