Provider Demographics
NPI:1174709919
Name:CADELL, DAVID SHANNON (CRNA)
Entity type:Individual
Prefix:MR
First Name:DAVID
Middle Name:SHANNON
Last Name:CADELL
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14721 LAKE MAGDALENE CIR
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33613-1704
Mailing Address - Country:US
Mailing Address - Phone:312-833-4640
Mailing Address - Fax:
Practice Address - Street 1:14721 LAKE MAGDALENE CIR
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33613-1704
Practice Address - Country:US
Practice Address - Phone:312-833-4640
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-01-10
Last Update Date:2024-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN9479351367500000X
WI165135367500000X
IL209008989367500000X
FLARNP9479351367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered