Individual
CARA MARJORIE ANNE CANNON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5950 SOUTH FLORIDA AVE., LAKELAND, FL 33813-2532
(863) 688-3550
Mailing address
2274 CHESTERFIELD CIR, LAKELAND, FL 33813-5837
(863) 688-3550
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
ME124168
FL
390200000X
Student in an Organized Health Care Education/Training Program
164586
NC
Other
Enumeration date
06/04/2010
Last updated
08/31/2015
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