Individual
MICHAEL CANNIZZARO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPN
Contact information
Practice address
10455 CORKSCREW COMMONS DR APT 102, ESTERO, FL 33928-9480
(239) 699-9413
Mailing address
10455 CORKSCREW COMMONS DR APT 102, ESTERO, FL 33928-9480
(239) 699-9413
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
PN11520
FL
Other
Enumeration date
10/07/2016
Last updated
10/07/2016
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