MEDICARE: DEBORAH E KANTOR ARNP

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	363L00000X	Nurse Practitioner	9226387	FL

General Provider Information

NPI Number	:	1275870651
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DEBORAH E KANTOR ARNP

Provider Business Mailing Address
First Line	:	6320 VENTURE DR
Second Line	:	SUITE 205
City	:	LAKEWOOD RANCH
State	:	FL
Zip	:	34202-5130
Country	:	US
Telephone Number	:	941-907-1595
Fax Number	:	941-761-6888

Provider Business Practice Location Address
First Line	:	5460 63RD ST E
Second Line	:	SUITE A
City	:	BRADENTON
State	:	FL
Zip	:	34203-7808
Country	:	US
Telephone Number	:	941-758-0379
Fax Number	:	941-272-7503

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

Provider Enumeration Date	:	01/06/2013
Last Update Date	:	01/06/2013

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