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NPI Code Detail

MEDICARE: GINA MARIE CANTATORE

MEDICARE: GINA MARIE CANTATORE
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
1390200000XStudent in an Organized Health Care Education/Training Program

General Provider Information

NPI Number : 1154279131
Entity Type Code : Individual
Provider Name (Legal Business Name) : GINA MARIE CANTATORE
Provider Business Mailing Address
First Line : 19 N WISCONSIN AVE
Second Line :
City : MASSAPEQUA
State : NY
Zip : 11758-1731
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 313 S LAKEWOOD DR
Second Line :
City : BRANDON
State : FL
Zip : 33511-2815
Country : US
Telephone Number : 813-349-7900
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/17/2026
Last Update Date : 03/17/2026

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Directions to “ GINA MARIE CANTATORE ” Practice Location

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