Provider Demographics
NPI:1235296518
Name:CANTAVE, EMMLYN (MD)
Entity Type:Individual
Prefix:DR
First Name:EMMLYN
Middle Name:
Last Name:CANTAVE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5586 LAKEWOOD CIR
Mailing Address - Street 2:APT H
Mailing Address - City:MARGATE
Mailing Address - State:FL
Mailing Address - Zip Code:33063-5240
Mailing Address - Country:US
Mailing Address - Phone:954-975-8306
Mailing Address - Fax:
Practice Address - Street 1:5586 LAKEWOOD CIR
Practice Address - Street 2:APT H
Practice Address - City:MARGATE
Practice Address - State:FL
Practice Address - Zip Code:33063-5240
Practice Address - Country:US
Practice Address - Phone:954-975-8306
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME954082085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology