Provider Demographics
NPI:1457399586
Name:KALTER, HOWARD M (PHD)
Entity Type:Individual
Prefix:DR
First Name:HOWARD
Middle Name:M
Last Name:KALTER
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1777 TAMIAMI TRL
Mailing Address - Street 2:STE 403
Mailing Address - City:PT CHARLOTTE
Mailing Address - State:FL
Mailing Address - Zip Code:33948-4001
Mailing Address - Country:US
Mailing Address - Phone:239-403-8883
Mailing Address - Fax:239-403-8881
Practice Address - Street 1:1777 TAMIAMI TRL
Practice Address - Street 2:STE 403
Practice Address - City:PT CHARLOTTE
Practice Address - State:FL
Practice Address - Zip Code:33948-4001
Practice Address - Country:US
Practice Address - Phone:239-403-8883
Practice Address - Fax:239-403-8881
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-02
Last Update Date:2021-10-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLPY5251103G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL59727OtherBCBS PROVIDER ID
FL59727OtherBCBS PROVIDER ID