Provider Demographics
NPI:1427047307
Name:MCCANE, CAMERON MITCHELL (DC)
Entity type:Individual
Prefix:DR
First Name:CAMERON
Middle Name:MITCHELL
Last Name:MCCANE
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 15576
Mailing Address - Street 2:
Mailing Address - City:BROOKSVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:34604-0120
Mailing Address - Country:US
Mailing Address - Phone:352-686-5122
Mailing Address - Fax:352-686-6985
Practice Address - Street 1:3037 LANDOVER BLVD
Practice Address - Street 2:
Practice Address - City:SPRING HILL
Practice Address - State:FL
Practice Address - Zip Code:34608-7260
Practice Address - Country:US
Practice Address - Phone:352-686-5122
Practice Address - Fax:352-686-6985
Is Sole Proprietor?:No
Enumeration Date:2005-10-13
Last Update Date:2010-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH 6360111N00000X
GACHIR004879111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL380389900Medicaid
FL22766Medicare ID - Type Unspecified
FL380389900Medicaid