Provider Demographics
NPI:1316974066
Name:CANTWELL, G PATRICIA (MD)
Entity type:Individual
Prefix:DR
First Name:G
Middle Name:PATRICIA
Last Name:CANTWELL
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:1601 NW 12TH AVE
Mailing Address - Street 2:BOX 016960 M851
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33101-6960
Mailing Address - Country:US
Mailing Address - Phone:305-243-4029
Mailing Address - Fax:305-243-8470
Practice Address - Street 1:1601 NW 12TH AVE
Practice Address - Street 2:BOX 016960 M851
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33101-6960
Practice Address - Country:US
Practice Address - Phone:305-243-4029
Practice Address - Fax:305-243-8470
Is Sole Proprietor?:No
Enumeration Date:2006-06-27
Last Update Date:2021-07-13
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FLME472492080H0002X, 2080P0203X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080H0002XAllopathic & Osteopathic PhysiciansPediatricsHospice and Palliative Medicine
No2080P0203XAllopathic & Osteopathic PhysiciansPediatricsPediatric Critical Care Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL0618381-00Medicaid
FL09603Medicare ID - Type Unspecified
FL0618381-00Medicaid