MEDICARE: AMY LITTLETON CANNELLA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363L00000X	Nurse Practitioner	9323706	FL

General Provider Information

NPI Number	:	1356814792
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMY LITTLETON CANNELLA

Provider Business Mailing Address
First Line	:	1513 PLEASANT HARBOUR WAY
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33602-5966
Country	:	US
Telephone Number	:	803-341-0402
Fax Number	:

Provider Business Practice Location Address
First Line	:	1513 PLEASANT HARBOUR WAY
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33602-5966
Country	:	US
Telephone Number	:	803-341-0402
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/08/2019
Last Update Date	:	01/27/2026

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