Healthcare Provider Details

I. General information

NPI: 1669344990
Provider Name (Legal Business Name): AUSTIN CANTARA
Entity Type: Individual
Gender:
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/17/2025
Last Update Date: 10/24/2025
Certification Date: 09/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7 VICTORY AVE
BIDDEFORD ME
04005-3605
US

IV. Provider business mailing address

7 VICTORY AVE
BIDDEFORD ME
04005-3605
US

V. Phone/Fax

Practice location:
  • Phone: 207-329-0502
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code146L00000X
TaxonomyParamedic
License Number28544
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: