MEDICARE: CHRISTOPHER MARK MCCANN OD

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
1	152W00000X	Optometrist	OPC4349	FL
2	152W00000X	Optometrist	2095	NC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1730332099
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRISTOPHER MARK MCCANN OD

Provider Business Mailing Address
First Line	:	4101 HUNTERS PARK LN
Second Line	:	STE 400
City	:	ORLANDO
State	:	FL
Zip	:	32837-3618
Country	:	US
Telephone Number	:	407-855-6132
Fax Number	:	407-704-7605

Provider Business Practice Location Address
First Line	:	4101 HUNTERS PARK LN
Second Line	:	STE 400
City	:	ORLANDO
State	:	FL
Zip	:	32837-3618
Country	:	US
Telephone Number	:	407-855-6132
Fax Number	:	407-704-7605

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/30/2008
Last Update Date	:	01/03/2016

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