Provider Demographics
NPI:1053852665
Name:STEVEN R CANTOR DC PA
Entity Type:Organization
Organization Name:STEVEN R CANTOR DC PA
Other - Org Name:PALM BEACH PAIN & REHABILITATION
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:
Authorized Official - Last Name:CANTOR
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:561-750-5416
Mailing Address - Street 1:307 VIA DE PALMAS
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33432-6007
Mailing Address - Country:US
Mailing Address - Phone:561-750-5416
Mailing Address - Fax:561-750-5417
Practice Address - Street 1:307 VIA DE PALMAS
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33432-6007
Practice Address - Country:US
Practice Address - Phone:561-750-5416
Practice Address - Fax:561-750-5417
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-15
Last Update Date:2017-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
111N00000X, 363L00000X
FLCH8058111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty