Look up the most recent NPI and PECOS records

Aldo Pavon Canseco

Internal Medicine

Allopathic & Osteopathic Physicians

PECOS Enrollment

Based on the most recent information from CMS, provider Aldo Pavon Canseco is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records yesterday at 12:57 PM.

Profile Details

Provider ID
1881870202
Provider Type
Individual
Full Name
Pavon Canseco, Aldo
Title
Dr.
Credential
M.D.

Gender
Male
Sole Proprietor
Yes
Enumeration Date
1/16/2008
Last Updated
3/21/2014

Contact Information

Practice Location

1400 NW 12th Ave, Miami, FL 33136-1003

(305) 325-5511

Unlisted Fax

Mailing Location

1400 NW 12th Ave, Miami, FL 33136-1003

(305) 243-2292

(305) 243-9927

Provider Taxonomies

Code	Description	License
Code 207R00000X Primary	Description Internal Medicine Allopathic & Osteopathic Physicians	License ME100762 Florida
Code 208M00000X	Description Hospitalist Allopathic & Osteopathic Physicians	License ME0100762 Florida

Provider Identifiers

ID	Description	Issuer
ID 0005037-00	Description Medicaid	Issuer Unlisted Florida

Aldo Pavon Canseco

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Code

Description

License

Provider Identifiers

ID

Description

Issuer

ID

Description

Issuer

Anaya, Candido

University Of Miami

Harlamova, Oxana

Debenedictus, Christina

Clauss, Stephanie Bromante

Dewan, Neelesh

Drice, Jenny

Mendha, Taaha Amin

Kaufman, Katelyn Elyse

Fernandez-Nosti, Yanelys R