Healthcare Provider Details

I. General information

NPI: 1538096672
Provider Name (Legal Business Name): PATRICK CANTY
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/05/2026
Last Update Date: 05/05/2026
Certification Date: 05/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2524 COUNTY ROAD 220
MIDDLEBURG FL
32068-6532
US

IV. Provider business mailing address

2052 HENLEY RD
MIDDLEBURG FL
32068-8269
US

V. Phone/Fax

Practice location:
  • Phone: 904-736-5350
  • Fax:
Mailing address:
  • Phone: 904-250-4776
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: