Healthcare Provider Details

I. General information

NPI: 1053852665
Provider Name (Legal Business Name): STEVEN R CANTOR DC PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/15/2017
Last Update Date: 03/29/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

307 VIA DE PALMAS
BOCA RATON FL
33432-6007
US

IV. Provider business mailing address

307 VIA DE PALMAS
BOCA RATON FL
33432-6007
US

V. Phone/Fax

Practice location:
  • Phone: 561-750-5416
  • Fax: 561-750-5417
Mailing address:
  • Phone: 561-750-5416
  • Fax: 561-750-5417

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: DR. STEVEN CANTOR
Title or Position: OWNER
Credential: DC
Phone: 561-750-5416