Edison Jose Cano Cevallos, M.D.

Primary specialty

Infectious Disease PhysicianTaxonomy code 207RI0200X

License

ME151652 Issued in FL

Practice address

5647 Hollywood Blvd
Hollywood, FL 33021-6325

Phone

(954) 276-1616

Fax

(954) 276-0186

NPI assigned

Aug 8, 2015

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 4

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in FL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Infectious Disease

Education

Other, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

South Broward Hospital DistrictGroup PAC ID 8123927373, 659 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Memorial Regional Hospital Hospital, Hollywood, FL, CCN 100038
• Memorial Hospital West Hospital, Pembroke Pines, FL, CCN 100281

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• South Broward Hospital District

  • Infectious Disease Physician
  • Hollywood, FL
  • NPI 1356712277
  Medicare reassignment Care Compare group NPD
• South Broward Hospital District

  • Home Infusion Therapy Pharmacy
  • Miramar, FL
  • NPI 1043656614
  NPD
• South Broward Hospital District

  • Pediatric Orthopaedic Surgery Physician
  • Hollywood, FL
  • NPI 1407865520
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• South Broward Hospital District

  • General Acute Care Hospital
  • Pembroke Pines, FL
  • NPI 1134102080
  Care Compare affiliation
• South Broward Hospital District

  • General Acute Care Hospital
  • Hollywood, FL
  • NPI 1780667923
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1438992000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646784000000",
    "number": "1982080339",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2900 CORPORATE WAY",
            "address_2": "DOOR D",
            "city": "MIRAMAR",
            "state": "FL",
            "postal_code": "330253925",
            "telephone_number": "954-276-5685",
            "fax_number": "954-985-7074"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5647 HOLLYWOOD BLVD",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330216325",
            "telephone_number": "954-276-1616",
            "fax_number": "954-276-0186"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "601 N Flamingo Rd Ste 302",
            "address_purpose": "LOCATION",
            "city": "Pembroke Pines",
            "state": "FL",
            "postal_code": "330281010",
            "country_code": "US",
            "telephone_number": "954-276-1616",
            "fax_number": "954-276-0186",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CANO CEVALLOS",
        "first_name": "EDISON",
        "middle_name": "JOSE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-08-08",
        "last_updated": "2022-03-09",
        "certification_date": "2022-03-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME151652",
            "primary": false
        },
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "MN",
            "license": "63792",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "FL",
            "license": "ME151652",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "111150900",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Cancer Healthcare Associates, P.L.
• Lori Ann Cancio, LCSW
• Catheryn Cristina Candanoza, FNP-BC
• Yesell Candelario Benitez, DDS
• Dalinda A Canela-Pichardo, DDS
• Cano Health, LLC
• Cano Pediatrics, LLC
• Roberto A Cano, M.D.
• Hedia D. Cantor, SPEECH THERAPIST
• Capital Care Medical Supply

• Infectious Disease Physician in Hollywood, FL
• Providers in Hollywood, FL by specialty
• Infectious Disease Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.