Organization
MISS CENTER OF EXCELLENCE PA
Active
Organization
MISS CENTER OF EXCELLENCE PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANDREW F CANNESTRA MD (OWNER)
(904) 343-1185
Entity
Organization
Contact information
Practice address
4530-15 ST JOHNS AVENUE 396, 396, JACKSONVILLE, FL 32210
(904) 451-7144
Mailing address
4530-15 ST JOHNS AVENUE 396, 396, JACKSONVILLE, FL 32210
(904) 451-7144
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
—
—
Other
Enumeration date
02/15/2022
Last updated
02/15/2022
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