Provider Demographics
NPI:1841734266
Name:MCCANTS, JOHN
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:
Last Name:MCCANTS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1302 DETOUR RD
Mailing Address - Street 2:
Mailing Address - City:HAINES CITY
Mailing Address - State:FL
Mailing Address - Zip Code:33844-9304
Mailing Address - Country:US
Mailing Address - Phone:863-326-8688
Mailing Address - Fax:
Practice Address - Street 1:1302 DETOUR RD
Practice Address - Street 2:
Practice Address - City:HAINES CITY
Practice Address - State:FL
Practice Address - Zip Code:33844-9304
Practice Address - Country:US
Practice Address - Phone:863-326-8688
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-12-05
Last Update Date:2016-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL195243146N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes146N00000XEmergency Medical Service ProvidersEmergency Medical Technician, Basic
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL016319000Medicaid