Cano Cevallos, Edison Jose
Cano Cevallos, Edison Jose is an individual health care provider with primary practice located at 5647 Hollywood Blvd , Hollywood FL 33021-6325. He recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Infectious Disease, Student, Health Care / Student in an Organized Health Care Education/Training Program. Allopathic & Osteopathic Physicians / Infectious Disease is his primary health care specialty. Cano Cevallos, Edison Jose can be contacted via phone (954) 276-1616.Contact Information
Primary practice address
5647 Hollywood Blvd
Hollywood FL 33021-6325
Phone: (954) 276-1616
Fax: (954) 276-0186
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | ME151652 | Florida |
| Allopathic & Osteopathic Physicians / Infectious Disease | 207RI0200X | 63792 | Minnesota |
| Student, Health Care / Student in an Organized Health Care Education/Training Program | 390200000X | ||
| Allopathic & Osteopathic Physicians / Infectious Disease | 207RI0200X | ME151652 | Florida |
Profile Details
| NPI number | 1982080339 |
|---|---|
| LBN Legal business name | Cano Cevallos, Edison Jose |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 8th, 2015 |
| Last updated | Mar 9th, 2022 - about 4 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1982080339 | NPPES |
| Florida | MEDICAID | 111150900 |
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