Individual
MR. JIMMIE DEAN CANOLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2979 S HWY A1A, UNIT 224, MELBOURNE BEACH, FL 32951-2881
(321) 223-9822
(321) 723-7720
Mailing address
2979 S HWY A1A, UNIT 224, MELBOURNE BEACH, FL 32951-2881
(321) 223-9822
(321) 723-7720
Taxonomy
Speciality
Code
Description
License number
State
251X00000X
Supports Brokerage Agency
Primary
A039719
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
573494
NATIONAL PRODUCER NUMBER
FL
Enumeration date
10/02/2015
Last updated
10/02/2015
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