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General NPI Number Information
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NPI Number | 1124412085
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Entity Type | Individual
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Provider Name | VICTORIA AUGUSTA CANNON M.D.
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Gender | Female
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Dates
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Enumeration Date | 03/27/2015
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Last Update Date | 11/18/2025
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Provider Practice Location Address
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Address Line | 5101 COLLINS AVE APT 14N
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City | MIAMI BEACH
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State | FL
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Zip | 33140-2727
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Country | US
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Telephone | 800-348-4565
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Fax | 888-203-4247
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Provider Business Mailing Address
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Address Line | 3 MARYLAND FARMS STE 200
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City | BRENTWOOD
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State | TN
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Zip | 37027-5780
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Country | US
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Telephone | 800-348-4565
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Fax | 888-203-4247
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number | 2021047367
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License Number State | MO
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Taxonomy #2
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number | MD2023-1516
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License Number State | NM
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Taxonomy #3
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number | ME176665
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License Number State | FL
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Taxonomy #4
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number | A162676
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License Number State | CA
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Taxonomy #5
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number | DR.0067131
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License Number State | CO
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