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Individual

MARYURI BRICENO CANNON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
653-1 W 8TH ST FL 4, JACKSONVILLE, FL 32209-6511
(904) 633-4199
(904) 633-4188
Mailing address
11684 WHITE DOGWOOD RD # 32256, JACKSONVILLE, FL 32256-8188
(786) 683-7852

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
ME161065
FL
390200000X
Student in an Organized Health Care Education/Training Program
FL

Other

Enumeration date
03/24/2020
Last updated
06/20/2023
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