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General NPI Number Information
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NPI Number | 1558179515
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Entity Type | Individual
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Provider Name | QUANISHA CANNON
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Gender | Female
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Dates
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Enumeration Date | 12/23/2024
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Last Update Date | 01/13/2025
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Provider Practice Location Address
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Address Line | 3702 W SPRUCE ST # 1117
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City | TAMPA
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State | FL
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Zip | 33607-2553
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Country | US
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Telephone | 800-303-4214
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Fax |
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Provider Business Mailing Address
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Address Line | 3702 W SPRUCE ST # 1117
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City | TAMPA
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State | FL
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Zip | 33607-2553
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Country | US
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Telephone | 800-303-4214
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Fax |
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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 | 171400000X
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Taxonomy Name | Health & Wellness Coach
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 172V00000X
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Taxonomy Name | Community Health Worker
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License Number |
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Taxonomy #3
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Taxonomy Code | 175F00000X
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Taxonomy Name | Naturopath
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License Number |
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Taxonomy #4
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Taxonomy Code | 175L00000X
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Taxonomy Name | Homeopath
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Taxonomy #5
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Taxonomy Code | 2081N0008X
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Taxonomy Name | Neuromuscular Medicine (Physical Medicine & Rehabilitation) Physician
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License Number | QC23WF5122
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License Number State | FL
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Taxonomy #6
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Taxonomy Code | 106S00000X
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Taxonomy Name | Behavior Technician
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Taxonomy #7
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Taxonomy Code | 133NN1002X
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Taxonomy Name | Nutrition Education Nutritionist
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Taxonomy #8
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Taxonomy Code | 202D00000X
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Taxonomy Name | Integrative Medicine Physician
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License Number | IM12QC56970
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License Number State | MO
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Taxonomy #9
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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Taxonomy #10
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Taxonomy Code | 251G00000X
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Taxonomy Name | Community Based Hospice Care Agency
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Taxonomy #11
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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Taxonomy #12
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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Taxonomy #13
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Taxonomy Code | 374J00000X
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Taxonomy Name | Doula
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License Number |
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Taxonomy #14
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Taxonomy Code | 374K00000X
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Taxonomy Name | Religious Nonmedical Practitioner
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