Individual
PROF. CANUTE LIVINGSTONE MCKAIN JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1065 ABAGAIL DR, DELTONA, FL 32725-6468
(386) 898-6238
Mailing address
PO BOX 5563, DELTONA, FL 32728-5563
(386) 898-6238
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
M250-112-64-341-0
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
172A00000X
—
FL
Enumeration date
01/02/2023
Last updated
01/02/2023
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