Provider Demographics
NPI:1629055256
Name:CANTOR, SAMUEL NEAL (DPM)
Entity Type:Individual
Prefix:DR
First Name:SAMUEL
Middle Name:NEAL
Last Name:CANTOR
Suffix:
Gender:M
Credentials:DPM
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Mailing Address - Street 1:8200 NW 27 ST
Mailing Address - Street 2:STE 108
Mailing Address - City:DORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33122-1906
Mailing Address - Country:US
Mailing Address - Phone:786-662-3893
Mailing Address - Fax:786-662-3899
Practice Address - Street 1:601 N FLAMINGO RD
Practice Address - Street 2:SUITE 403
Practice Address - City:PEMBROKE PINES
Practice Address - State:FL
Practice Address - Zip Code:33028-1012
Practice Address - Country:US
Practice Address - Phone:954-443-5757
Practice Address - Fax:954-374-8883
Is Sole Proprietor?:No
Enumeration Date:2005-12-23
Last Update Date:2015-12-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FLPO1051213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLPO-1051OtherSTATE LICENSE NUMBER
FL041286400Medicaid
FL041286400Medicaid
FLPO-1051OtherSTATE LICENSE NUMBER