Individual
CHANDRA DEVI JAYA KANTOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
3715 7TH TER, VERO BEACH, FL 32960-6571
(772) 770-2664
(772) 770-3506
Mailing address
3715 7TH TERRACE, VERO BEACH, FL 32960
(772) 770-2664
(772) 770-3506
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
2173832
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
303173000
—
FL
Enumeration date
07/11/2006
Last updated
07/27/2009
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