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General NPI Number Information
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NPI Number | 1669866539
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Entity Type | Individual
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Provider Name | GREGORY J CANNARSA MD
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Gender | Male
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Dates
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Enumeration Date | 03/27/2015
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Last Update Date | 08/02/2023
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Provider Practice Location Address
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Address Line | 3530 KRAFT RD STE 203
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City | NAPLES
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State | FL
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Zip | 34105-5020
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Country | US
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Telephone | 239-422-2739
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Fax | 239-529-5695
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Provider Business Mailing Address
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Address Line | 3530 KRAFT RD STE 203
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City | NAPLES
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State | FL
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Zip | 34105-5020
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Country | US
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Telephone | 239-422-2739
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Fax | 239-529-5695
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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 | 207T00000X
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Taxonomy Name | Neurological Surgery Physician
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License Number | ME158122
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License Number State | FL
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