Active NPI
Alissa G Cannon
- Student in an Organized Health Care Education/Training Program
- Cocoa, FL
National Provider Identifier
1821634296
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Student in an Organized Health Care Education/Training Program
- License
- PSI48038
- Practice address
- 2324 State Road 524
Cocoa, FL 32926-5893 - Phone
- (321) 636-9335
- NPI assigned
- Nov 20, 2019
- Last updated
- Sep 4, 2025
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | PSI48038 | FL | Primary |
| Pharmacy Technician | 183700000X | RPT53347 | FL |
Addresses
Primary practice location
2324 State Road 524
Cocoa, FL 32926-5893
Mailing address
2321 Planter Ridge CT SE
Palm Bay, FL 32909-6850
Phone (321) 514-7080
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RPT53347 | FL | MD | Pharmacy Technician |
| PSI48038 | FL | MD | Student in an Organized Health Care Education/Training Program |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Holiday CVS LLC | Past | Accepting new patients | |
| Holiday CVS L.L.C. | Past | Accepting new patients | |
| Holiday CVS LLC | Past | Accepting new patients |
Organizations & group practices 3
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1574208000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1756944000000",
"number": "1821634296",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2321 PLANTER RIDGE CT SE",
"city": "PALM BAY",
"state": "FL",
"postal_code": "329096850",
"telephone_number": "321-514-7080"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2324 STATE ROAD 524",
"city": "COCOA",
"state": "FL",
"postal_code": "329265893",
"telephone_number": "321-636-9335"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CANNON",
"first_name": "ALISSA",
"middle_name": "G",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-11-20",
"last_updated": "2025-09-04",
"certification_date": "2025-09-04",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "FL",
"license": "PSI48038",
"primary": true
},
{
"code": "183700000X",
"taxonomy_group": "",
"desc": "Pharmacy Technician",
"state": "FL",
"license": "RPT53347",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Cocoa, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.