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NPI Code Detail

MEDICARE: MR. LARRY JAMES CANN RN

MEDICARE: MR. LARRY JAMES CANN RN
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
1163W00000XRegistered NurseRN3362502FL

General Provider Information

NPI Number : 1679531727
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. LARRY JAMES CANN RN
Provider Business Mailing Address
First Line : 721 SAWYER ST
Second Line :
City : LEHIGH
State : FL
Zip : 33936-0716
Country : US
Telephone Number : 239-369-4046
Fax Number :
Provider Business Practice Location Address
First Line : 1140 PRATT BLVD
Second Line :
City : LABELLE
State : FL
Zip : 33935-4405
Country : US
Telephone Number : 863-674-4041
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/01/2006
Last Update Date : 07/08/2007

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