Provider Demographics
NPI:1780685057
Name:KANTER, GEOFFREY (PH D)
Entity Type:Individual
Prefix:DR
First Name:GEOFFREY
Middle Name:
Last Name:KANTER
Suffix:
Gender:M
Credentials:PH D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1250 S TAMIAMI TRL STE 201
Mailing Address - Street 2:COMPREHENSIVE MEDPSYCH SYSTEMS
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34239-2221
Mailing Address - Country:US
Mailing Address - Phone:941-363-0868
Mailing Address - Fax:941-363-0627
Practice Address - Street 1:1250 S TAMIAMI TRL
Practice Address - Street 2:SUITE 201
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34239-2221
Practice Address - Country:US
Practice Address - Phone:941-363-0868
Practice Address - Fax:941-363-0627
Is Sole Proprietor?:No
Enumeration Date:2005-08-09
Last Update Date:2009-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY4749103T00000X, 103G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist
No103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL59366Medicare ID - Type Unspecified