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Individual

ALISSA G CANNON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
2324 STATE ROAD 524, COCOA, FL 32926-5893
(321) 636-9335
Mailing address
2321 PLANTER RIDGE CT SE, PALM BAY, FL 32909-6850
(321) 514-7080

Taxonomy

Speciality
Code
Description
License number
State
183700000X
Pharmacy Technician
RPT53347
FL
390200000X
Student in an Organized Health Care Education/Training Program
Primary
PSI48038
FL

Other

Enumeration date
11/20/2019
Last updated
09/04/2025
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