Individual
CHRISTOPHER J GANNON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1150 N 35TH AVE STE 650, HOLLYWOOD, FL 33021
(954) 265-9520
(954) 265-9546
Mailing address
2900 CORPORATE WAY, DOOR D, MIRAMAR, FL 33025-3925
(954) 276-5685
(954) 985-7074
Taxonomy
Speciality
Code
Description
License number
State
2086X0206X
Surgical Oncology Physician
Primary
ME126000
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
016045600
—
FL
Enumeration date
09/20/2006
Last updated
03/16/2021
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