Provider Demographics
NPI:1184022345
Name:KANTOR, NOYA (PA-C)
Entity Type:Individual
Prefix:
First Name:NOYA
Middle Name:
Last Name:KANTOR
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:603 N FLAMINGO ROAD SUITE 350
Mailing Address - Street 2:
Mailing Address - City:PEMBROKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33028-1013
Mailing Address - Country:US
Mailing Address - Phone:954-435-5100
Mailing Address - Fax:954-435-5816
Practice Address - Street 1:2625 EXECUTIVE PARK DRIVE
Practice Address - Street 2:SUITE 7
Practice Address - City:WESTON
Practice Address - State:FL
Practice Address - Zip Code:33331-3634
Practice Address - Country:US
Practice Address - Phone:954-385-1544
Practice Address - Fax:954-385-1533
Is Sole Proprietor?:No
Enumeration Date:2014-12-19
Last Update Date:2014-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPA9108287363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant