Monique M Cannon

Primary specialty

HomemakerTaxonomy code 376J00000X

License

240448 Issued in FL

Practice address

352 Tanglewood Dr
Davenport, FL 33896-3106

Phone

(317) 361-7923

NPI assigned

Mar 18, 2025

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Supportive Space Home Care

  • Homemaker
  • Davenport, FL
  • NPI 1184592404
  NPD Authorized official

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

{
    "created_epoch": "1742256000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742256000000",
    "number": "1841090693",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10245 PEPPERIDGE DR",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462351242",
            "telephone_number": "317-361-7923"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "352 TANGLEWOOD DR",
            "city": "DAVENPORT",
            "state": "FL",
            "postal_code": "338963106",
            "telephone_number": "317-361-7923"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CANNON",
        "first_name": "MONIQUE",
        "middle_name": "M",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-03-18",
        "last_updated": "2025-03-18",
        "certification_date": "2025-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "376J00000X",
            "taxonomy_group": "",
            "desc": "Homemaker",
            "state": "FL",
            "license": "240448",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cambo Medical Services Inc
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• Cristin Campbell, NP-C
• Lourdes Patricia Campo Sr.
• Carcamo Care Pediatrics, Inc
• Antonio De Jesus Carcamo, MD
• Carifi Breast Care PA
• Vincent G Carifi, M.D.
• Luis Andres Carmona Gomez, RBT-24-392249

• Homemaker in Davenport, FL
• Providers in Davenport, FL by specialty
• Homemaker in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 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.

Verify at the official NPI Registry.