MEDICARE: MS. KAREN LEE CANTZ CPHT

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	183700000X	Pharmacy Technician	2501--0010-3031-060	FL

General Provider Information

NPI Number	:	1902909203
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. KAREN LEE CANTZ CPHT

Provider Business Mailing Address
First Line	:	10058 SW VICTORY DR
Second Line	:
City	:	ARCADIA
State	:	FL
Zip	:	34269-6752
Country	:	US
Telephone Number	:	941-743-0323
Fax Number	:	941-505-9657

Provider Business Practice Location Address
First Line	:	27680 BERMONT RD
Second Line	:
City	:	PUNTA GORDA
State	:	FL
Zip	:	33982
Country	:	US
Telephone Number	:	941-505-9583
Fax Number	:	941-505-9657

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

Provider Enumeration Date	:	09/06/2006
Last Update Date	:	07/08/2007

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