Canaan, Antonio

Canaan, Antonio is an individual health care provider with primary practice located at 1220 Willis Ave , Daytona Beach FL 32114-2810. He recently has only one registered license in Allopathic & Osteopathic Physicians / Psychiatry, which is considered as his primary health care specialty. Canaan, Antonio can be contacted via phone (386) 236-3200.

Contact Information

Primary practice address
1220 Willis Ave Daytona Beach FL 32114-2810
Phone: (386) 236-3200
Fax: (386) 236-3161
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Psychiatry 2084P0800X ME60487 Florida

Profile Details

NPI number 1588722854
LBN Legal business name Canaan, Antonio
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 5th, 2006
Last updated Sep 17th, 2009 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1588722854 NPPES
Florida Other 14325 BCBS
Florida MEDICAID 056828700 BCBS

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