MR. CHARLES ALAN CANTRELL (NPI# 1801317219) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1801317219 |
| Entity Type | Individual |
| Full Name | MR. CHARLES ALAN CANTRELL |
| Credential | ARNP, FNP-BC |
| Practice Address |
1300 Red John Dr Daytona Beach FL 32124-1075 |
| Practice Telephone | 3862541547 |
| Enumeration Date | 2017-07-06 |
| Last Update Date | 2017-07-06 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
RN2614672 | FL | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255560793 | Charles Richard Cantrell Jr. | Mechanotherapist | 105 E Crandall Ave, Harrison, AR 72601-3629 | 2009-07-06 |
| 1568438307 | Charles R Cantrell | Anesthesiology | 1101 Jackson St Sw, Gravette, AR 72736-9121 | 2006-02-23 |
| Street Address |
1300 RED JOHN DR |
| City | DAYTONA BEACH |
| State | FL |
| Zip Code | 32124-1075 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265658744 | Jessika Gil-pineda | Family Medicine | 1300 Red John Dr, Daytona Beach, FL 32124-1075 | 2007-04-17 |
| 1578785473 | Douglas Lewis Massingill | Dentist | 1300 Red John Dr, Daytona Beach, FL 32124-1075 | 2007-05-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407302599 | Christine Lapila | Behavioral Analyst | 201 Thornberg Branch Lane, Daytona Beach, FL 32124 | 2016-08-29 |
| 1194708495 | Brent N. Fulton | Family Medicine | 3127 W International Speedway Blvd., Daytona Beach, FL 32124 | 2005-11-21 |
| 1891212130 | Brian Moore | Early Intervention Provider Agency | 201 Thornberry Branch Ln, Daytona Beach, FL 32124 | 2017-08-28 |
| 1588834725 | Glendoria Stephens | Counselor | 3875 Tiger Bay Rd, Rm 914 Bldg I, Daytona Beach, FL 32124 | 2008-03-04 |
| 1003146887 | Sequel Tsi of Florida, LLC Daytona Transitional | Residential Treatment Facility, Emotionally Disturbed Children | 1386 Indian Lake Rd, Daytona Beach, FL 32124-1001 | 2009-12-30 |
| 1376874370 | Sequel Tsi of Florida, LLC Daytona Residential Treatment Center | Psychiatric Residential Treatment Facility | 1386 Indian Lake Rd, Daytona Beach, FL 32124-1001 | 2010-01-15 |
| 1710531454 | Publix Super Markets, Inc. | Durable Medical Equipment & Medical Supplies | 2630 Lpga Blvd, Daytona Beach, FL 32124-1008 | 2019-07-31 |
| 1336746544 | Kyle Adams | Pharmacist | 2630 Lpga Blvd, Daytona Beach, FL 32124-1008 | 2020-10-01 |
| 1750369666 | Sma Healthcare Inc | Community/Behavioral Health | 1150 Red John Road, Daytona Beach, FL 32124-1016 | 2006-01-03 |
| 1396742490 | Theodore Frank Matejka | Nurse Practitioner | 1150 Red John Dr, Daytona Beach, FL 32124-1016 | 2005-07-05 |
| Find all providers in zip 32124 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346840378 | Dee Ann Akers | Nurse Practitioner | 2085 S Halifax Dr, Daytona Beach, FL 32118-5205 | 2020-10-28 |
| 1275140766 | Tolgonay Agamez-morales | Nurse Practitioner | 133 Integra Breeze Ln Unit 303, Daytona Beach, FL 32117-5585 | 2020-09-28 |
| 1144839861 | Amy Decker | Nurse Practitioner | 1329 Tomoka Town Center Dr Apt 102, Daytona Beach, FL 32117-5187 | 2020-07-28 |
| 1629691308 | Johana Daniels | Nurse Practitioner | 1437 Admiral Halsey Ave, Daytona Beach, FL 32124-3614 | 2020-05-28 |
| 1003436189 | Ashley Gillette | Nurse Practitioner | 112 Milton Rd, Daytona Beach, FL 32118-5411 | 2020-04-20 |
| 1871066373 | Tammy Jo Leggett | Nurse Practitioner | 826 N Wild Olive Ave, Daytona Beach, FL 32118-3727 | 2019-01-07 |
| 1184197949 | Maria Vessell | Nurse Practitioner | 311 N Clyde Morris Blvd Ste 550, Daytona Beach, FL 32114-2766 | 2019-01-04 |
| 1518433804 | Tara James | Nurse Practitioner | 224 Seabreeze Blvd, Daytona Beach, FL 32118 | 2018-10-15 |
| 1750899217 | Tayanna Giselle Lawlor | Nurse Practitioner | 1890 Lpga Blvd Ste 170, Daytona Beach, FL 32117-7131 | 2018-01-18 |
| 1871028803 | Susan Kamelgarn | Nurse Practitioner | 104 La Costa Lane, Suite 120, Daytona Beach, FL 32114 | 2017-04-27 |
| Find all providers in DAYTONA BEACH | ||||
| City | DAYTONA BEACH |
| Zip Code | 32124 |
Please comment or provide details below to improve the information on MR. CHARLES ALAN CANTRELL.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.