Provider Demographics
NPI:1154439982
Name:KANTOR, GEORGE STEPHEN (MD)
Entity Type:Individual
Prefix:
First Name:GEORGE
Middle Name:STEPHEN
Last Name:KANTOR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11211 PROSPERITY FARMS RD
Mailing Address - Street 2:C-114
Mailing Address - City:PALM BEACH GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33410-3446
Mailing Address - Country:US
Mailing Address - Phone:561-622-2546
Mailing Address - Fax:561-627-1757
Practice Address - Street 1:11211 PROSPERITY FARMS RD
Practice Address - Street 2:C-114
Practice Address - City:PALM BEACH GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33410-3446
Practice Address - Country:US
Practice Address - Phone:561-622-2546
Practice Address - Fax:561-627-1757
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0042161207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL61295Medicare ID - Type Unspecified
FLD57179Medicare UPIN