Individual
MR. LUIS CANTOR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1541 S WICKHAM RD, MELBOURNE, FL 32904-3540
(321) 726-6331
Mailing address
1541 S WICKHAM RD, MELBOURNE, FL 32904-3540
(321) 726-6331
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA9113587
FL
Other
Enumeration date
07/11/2020
Last updated
01/17/2021
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