Basic Information
Provider Information
NPI: 1609092048
EntityType: 2
ReplacementNPI:  
OrganizationName: MICHAEL Z KALTER M D M S P A
LastName:  
FirstName:  
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 7659
Address2:  
City: JUPITER
State: FL
PostalCode: 334687659
CountryCode: US
TelephoneNumber: 5617482889
FaxNumber: 5617481523
Practice Location
Address1: 1004 S OLD DIXIE HWY
Address2: SUITE 302
City: JUPITER
State: FL
PostalCode: 334587200
CountryCode: US
TelephoneNumber: 5617432222
FaxNumber: 5617433401
Other Information
ProviderEnumerationDate: 04/17/2007
LastUpdateDate: 06/11/2008
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode:  
AuthorizedOfficialLastName: BARLOW
AuthorizedOfficialFirstName: KAREN
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition: OWNER BILLING COMPANY
AuthorizedOfficialTelephone: 5617482889
IsSoleProprietor:  
IsOrganizationSubpart: N
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
208D00000XME53918FLY193400000X SINGLE SPECIALTY GROUPAllopathic & Osteopathic PhysiciansGeneral Practice 

No ID Information.


Home