Provider Demographics
NPI:1750380150
Name:KALTER, CRAIG S (MD)
Entity type:Individual
Prefix:MR
First Name:CRAIG
Middle Name:S
Last Name:KALTER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:13601 BRUCE B DOWNS BLVD
Mailing Address - Street 2:SUITE 250
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33613-4657
Mailing Address - Country:US
Mailing Address - Phone:813-971-6909
Mailing Address - Fax:813-971-6985
Practice Address - Street 1:1500 CONCORD TER
Practice Address - Street 2:
Practice Address - City:SUNRISE
Practice Address - State:FL
Practice Address - Zip Code:33323-2815
Practice Address - Country:US
Practice Address - Phone:800-243-3839
Practice Address - Fax:855-527-5510
Is Sole Proprietor?:No
Enumeration Date:2005-07-18
Last Update Date:2014-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0055944207VM0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VM0101XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyMaternal & Fetal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL062597301Medicaid
FLE84307Medicare UPIN
FL10136Medicare ID - Type Unspecified