MR. Jimmie Dean Canole

NPI #1659741627 in Melbourne Beach, Florida

Provider Information

NPI Number: 1659741627
Entity Type: Individual
Name: MR. Jimmie Dean Canole
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Supports Brokerage
Enumeration Date: Oct 2, 2015
Last Updated: Oct 2, 2015

Practice Location

Address: 2979 S HWY A1A
Address 2: UNIT 224
City: Melbourne Beach
State: Florida
ZIP Code: 32951-2881
Phone: (321) 223-9822

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Supports Brokerage	251X00000X	Primary

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