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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

MR. JIMMIE DEAN CANOLE

Active Sole Proprietor

MR. JIMMIE DEAN CANOLE is a Supports Brokerage Agency healthcare provider located in MELBOURNE BEACH, Florida. NPI 1659741627 is currently active in the NPPES registry. Verify at CMS.

Supports Brokerage Agency · MELBOURNE BEACH, FL

Registration Details

NPI Number
1659741627
Provider Type
Individual
Gender
Male
NPI Issued
Oct 2, 2015 (10.902801113092 yrs)
Last Updated
Oct 2, 2015
License
A039719 (FL)
Sole Proprietor
Yes

Practice Information

Address
2979 S HWY A1A
UNIT 224
MELBOURNE BEACH, FL, 329512881
Browse FL providers · Browse ZIP 32951
Phone
3212239822
Fax
3217237720
Primary Specialty
Supports Brokerage Agency
251X00000X
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.