Provider Demographics
NPI:1760446512
Name:CANTOR, SHERWOOD ROY (MD)
Entity Type:Individual
Prefix:DR
First Name:SHERWOOD
Middle Name:ROY
Last Name:CANTOR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:10344 SW 128TH TER
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33176-5520
Mailing Address - Country:US
Mailing Address - Phone:305-251-0449
Mailing Address - Fax:305-255-6169
Practice Address - Street 1:9275 SW 152ND ST
Practice Address - Street 2:SUITE #105
Practice Address - City:VILLAGE OF PALMETTO BAY
Practice Address - State:FL
Practice Address - Zip Code:33157-1701
Practice Address - Country:US
Practice Address - Phone:305-251-0449
Practice Address - Fax:305-255-6169
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-17
Last Update Date:2015-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME00176412084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL59-1682438OtherTAX ID NUMBER
FL92221Medicare PIN
FLD59993Medicare UPIN