Provider Demographics
NPI:1689778706
Name:CANCEL, JAIME (MD)
Entity Type:Individual
Prefix:
First Name:JAIME
Middle Name:
Last Name:CANCEL
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Gender:M
Credentials:MD
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Mailing Address - Street 1:4235 KINGS HIGHWAY
Mailing Address - Street 2:SUITE 103
Mailing Address - City:PORT CHARLOTTE
Mailing Address - State:FL
Mailing Address - Zip Code:33980-8421
Mailing Address - Country:US
Mailing Address - Phone:941-613-1777
Mailing Address - Fax:941-613-1779
Practice Address - Street 1:4235 KINGS HIGHWAY
Practice Address - Street 2:SUITE 103
Practice Address - City:PORT CHARLOTTE
Practice Address - State:FL
Practice Address - Zip Code:33980-8421
Practice Address - Country:US
Practice Address - Phone:941-613-1777
Practice Address - Fax:941-613-1779
Is Sole Proprietor?:No
Enumeration Date:2006-09-11
Last Update Date:2018-11-21
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Provider Licenses
StateLicense IDTaxonomies
FLME137658207RC0200X, 207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine