Provider Demographics
NPI:1962671677
Name:SAMUEL N. CANTOR, D.P.M., P.A.
Entity Type:Organization
Organization Name:SAMUEL N. CANTOR, D.P.M., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PODIATRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:SAMUEL
Authorized Official - Middle Name:NEAL
Authorized Official - Last Name:CANTOR
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:305-835-8000
Mailing Address - Street 1:1190 NW 95TH ST
Mailing Address - Street 2:SUITE 108
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33150-2063
Mailing Address - Country:US
Mailing Address - Phone:305-835-8000
Mailing Address - Fax:305-835-0866
Practice Address - Street 1:1190 NW 95TH ST
Practice Address - Street 2:SUITE 108
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33150-2063
Practice Address - Country:US
Practice Address - Phone:305-835-8000
Practice Address - Fax:305-835-0866
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-27
Last Update Date:2008-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPO-1051332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLT55441Medicare UPIN