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NPI Code Detail

MEDICARE: THOMAS JOHN KANTARAS

MEDICARE: THOMAS JOHN KANTARAS
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 ProgramAZ

General Provider Information

NPI Number : 1306793609
Entity Type Code : Individual
Provider Name (Legal Business Name) : THOMAS JOHN KANTARAS
Provider Business Mailing Address
First Line : 4510 E BANNER GATEWAY DR APT 3120
Second Line :
City : MESA
State : AZ
Zip : 85206-4760
Country : US
Telephone Number : 330-814-2707
Fax Number :
Provider Business Practice Location Address
First Line : 5835 E STILL CIR
Second Line :
City : MESA
State : AZ
Zip : 85206-3618
Country : US
Telephone Number : 480-248-8107
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/14/2026
Last Update Date : 03/14/2026

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Directions to “ THOMAS JOHN KANTARAS ” Practice Location

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