Individual
JOSHUA CONCANNON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
298 MICHIGAN AVE STE 101, MELBOURNE, FL 32901-3104
(321) 215-6899
(321) 215-6789
Mailing address
11225 CYPRESS TRAIL DR, ORLANDO, FL 32825-5027
(407) 797-5058
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA9118972
FL
Other
Enumeration date
02/07/2022
Last updated
10/22/2024
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