Michael Cannizzaro, LPN

Individual provider Active NPI Licensed Practical Nurse · Estero, FL

NPI 1053861542 · NPPES record last updated Oct 7, 2016

Key facts

NPI
1053861542
Entity type
Individual (NPI type 1)
Primary specialty
Licensed Practical Nurse 164W00000X
License
PN11520 (FL)
Practice address
10455 Corkscrew Commons Dr Apt 102
Estero, FL 33928-9480
Phone
(239) 699-9413
NPI assigned
Oct 7, 2016
Sex
Male
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
PN11520FLMDLicensed Practical Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X PN11520 FL Yes

Addresses

Primary practice location

10455 Corkscrew Commons Dr Apt 102
Estero, FL 33928-9480

Mailing address

10455 Corkscrew Commons Dr Apt 102
Estero, FL 33928-9480
Phone (239) 699-9413

Other providers in Estero, FL

All providers in Estero, FL · Licensed Practical Nurse in Florida

Sources for this page

Verify at the official NPI Registry.