Healthcare Provider Details

I. General information

NPI: 1770597965
Provider Name (Legal Business Name): DAVID WILLIAM CAIN D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/27/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4333 US HIGHWAY 301 N
ELLENTON FL
34222-2413
US

IV. Provider business mailing address

6698 MEANDERING WAY
BRADENTON FL
34202-1823
US

V. Phone/Fax

Practice location:
  • Phone: 941-721-0649
  • Fax:
Mailing address:
  • Phone: 941-727-0135
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberOS8583
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: