MEDICARE: NEIL E KANTERMAN MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207W00000X	Ophthalmology Physician	ME88947	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1053318402
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NEIL E KANTERMAN MD

Provider Business Mailing Address
First Line	:	220 SW 84TH AVE
Second Line	:	SUITE 204
City	:	PLANTATION
State	:	FL
Zip	:	33324-2754
Country	:	US
Telephone Number	:	954-424-5959
Fax Number	:	954-424-1415

Provider Business Practice Location Address
First Line	:	220 SW 84TH AVE
Second Line	:	SUITE 204
City	:	PLANTATION
State	:	FL
Zip	:	33324-2754
Country	:	US
Telephone Number	:	954-424-5959
Fax Number	:	954-424-1415

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/30/2005
Last Update Date	:	10/03/2013

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