Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207T00000X | Neurosurgeon | ME86640 | FL |
NPI | 1114978459 |
---|---|
Provider Name | Dr. Alexa I Canady |
First Address | Pensacola, FL 32513-2699 |
Second Address | Pensacola, FL 32504-8785 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/05/2006 |
Last Update Date | 24/06/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
269754800 | (05) | FL |
E77891 | (02) | FL |