Individual
DR. NICOLE MCCANN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2 TAMPA GENERAL CIR, TAMPA, FL 33606-3571
(813) 821-8038
(813) 974-4325
Mailing address
PO BOX 917770, ORLANDO, FL 32891-0001
(813) 821-8038
(813) 974-4325
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
MD25165
ME
207RH0002X
Hospice and Palliative Medicine (Internal Medicine) Physician
Primary
ME156873
FL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
115355300
—
FL
01
—
2K0KX
BLUE CROSS BLUE SHIELD
FL
Enumeration date
03/25/2018
Last updated
10/12/2022
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