Active NPI
Didier Pierre De Canniere, MD
- Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
- Miami, FL
National Provider Identifier
1235455213
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
- License
- MFC1652
- Practice address
- 1611 NW 12TH Ave
Suite Central 3
Miami, FL 33136-1005 - Phone
- (305) 585-5271
- Fax
- (305) 547-2185
- NPI assigned
- Apr 15, 2010
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Vascular Surgery Physician | 2086S0129X | MFC1652 | FL | |
| Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician | 208G00000X | MFC1652 | FL | Primary |
Addresses
Primary practice location
1611 NW 12TH Ave
Suite Central 3
Miami, FL 33136-1005
Mailing address
1611 NW 12TH Ave
Suite Central 3
Miami, FL 33136-1005
Phone (305) 585-5271
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0020899-00 | Medicaid | FL |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- HHS exclusion list flag
- Flagged The directory lists this NPI on an HHS exclusion list.
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1271289600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1335830400000",
"number": "1235455213",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1611 NW 12TH AVE",
"address_2": "SUITE CENTRAL 3",
"city": "MIAMI",
"state": "FL",
"postal_code": "331361005",
"telephone_number": "305-585-5271",
"fax_number": "305-547-2185"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1611 NW 12TH AVE",
"address_2": "SUITE CENTRAL 3",
"city": "MIAMI",
"state": "FL",
"postal_code": "331361005",
"telephone_number": "305-585-5271",
"fax_number": "305-547-2185"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DE CANNIERE",
"first_name": "DIDIER",
"middle_name": "PIERRE",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2010-04-15",
"last_updated": "2012-05-01",
"status": "A"
},
"taxonomies": [
{
"code": "2086S0129X",
"taxonomy_group": "",
"desc": "Surgery, Vascular Surgery",
"state": "FL",
"license": "MFC1652",
"primary": false
},
{
"code": "208G00000X",
"taxonomy_group": "",
"desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
"state": "FL",
"license": "MFC1652",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0020899-00",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Miami, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.