Provider Demographics
NPI:1467843664
Name:CANCEL, ROXANA M (BS)
Entity Type:Individual
Prefix:
First Name:ROXANA
Middle Name:M
Last Name:CANCEL
Suffix:
Gender:F
Credentials:BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5300 W IRLO BRONSON HWY LOT 473
Mailing Address - Street 2:
Mailing Address - City:KISSIMMEE
Mailing Address - State:FL
Mailing Address - Zip Code:34746-4784
Mailing Address - Country:US
Mailing Address - Phone:407-873-3681
Mailing Address - Fax:
Practice Address - Street 1:5300 W IRLO BRONSON HWY LOT 473
Practice Address - Street 2:
Practice Address - City:KISSIMMEE
Practice Address - State:FL
Practice Address - Zip Code:34746-4784
Practice Address - Country:US
Practice Address - Phone:407-873-3681
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-02-09
Last Update Date:2015-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker