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Individual

EDISSON CANTOR

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
1 LELY HIGH SCHOOL BLVD, NAPLES, FL 34113-7823
(239) 377-1937
(239) 377-2190
Mailing address
3306 W LEROY ST, TAMPA, FL 33607-1128
(813) 545-7931

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AL2603
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
22
RESPIRATORY, REHABILITATIVE & RESTORATIVE SERVICE PROVIDERS
FL
Enumeration date
09/15/2017
Last updated
09/15/2017
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