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Individual
SHAY CANNON
Active
Individual
SHAY CANNON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Taxonomy
Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
9116245
FL
363A00000X
Physician Assistant
Primary
PA9116245
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
U49E2
BCBS
FL
Enumeration date
06/09/2022
Last updated
11/09/2022
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