Individual
ANTOINETTE C SPOTO-CANNONS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
17 DAVIS BLVD STE 100, TAMPA, FL 33606-3468
(813) 974-2201
(813) 974-2812
Mailing address
PO BOX 917770, ORLANDO, FL 32891-0001
(813) 974-2201
(813) 974-2812
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
ME72740
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
256487400
—
FL
01
—
46741
BLUE CROSS BLUE SHIELD
FL
Enumeration date
08/10/2006
Last updated
10/28/2020
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