Miss Center of Excellence PA

Primary specialty

Neurological Surgery PhysicianTaxonomy code 207T00000X

Legal business name

MISS CENTER OF EXCELLENCE PA

Practice address

4530-15 St Johns Avenue 396
396
Jacksonville, FL 32210

Phone

(904) 451-7144

NPI assigned

Feb 15, 2022

Last updated

Feb 15, 2022By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Andrew F Cannestra, MD

Title

Owner

Phone

(904) 343-1185

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1644883200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1644883200000",
    "number": "1588319925",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4530-15 ST JOHNS AVENUE 396",
            "address_2": "396",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "32210",
            "telephone_number": "904-451-7144"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4530-15 ST JOHNS AVENUE 396",
            "address_2": "396",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "32210",
            "telephone_number": "904-451-7144"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MISS CENTER OF EXCELLENCE PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-02-15",
        "last_updated": "2022-02-15",
        "certification_date": "2022-01-31",
        "status": "A",
        "authorized_official_last_name": "CANNESTRA",
        "authorized_official_first_name": "ANDREW",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "904-343-1185",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Neurological Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Katharyn I Mirzaee, MD
• Audrey O'Keefe Misel, PA-C
• Shreya Mishra
• Prishila Misimi, APRN
• Bharat K Misra, MD
• Missing Link Behavioral, LLC
• Missing Piece Behavioral Solutions LLC
• Mission Complete Transportation Services
• Mission Possible Transport, Inc
• Tyler Austin Mistretta, MD

• Neurological Surgery Physician in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Neurological Surgery Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.