1174548713 NPI number — DR. STEVEN ROY KANTER M.D. F.A.C.S.

Table of content: DR. STEVEN ROY KANTER M.D. F.A.C.S. (NPI 1174548713)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1174548713 NPI number — DR. STEVEN ROY KANTER M.D. F.A.C.S.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
KANTER
Provider First Name:
STEVEN
Provider Middle Name:
ROY
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
M.D. F.A.C.S.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1174548713
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/30/2017
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
8940 N KENDALL DR
Provider Second Line Business Mailing Address:
STE 803E
Provider Business Mailing Address City Name:
MIAMI
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33176-2151
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
305-279-9522
Provider Business Mailing Address Fax Number:
305-279-3218

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
8755 SW 94TH STREET
Provider Second Line Business Practice Location Address:
SUITE 200
Provider Business Practice Location Address City Name:
MIAMI
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33176-2416
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
305-279-9522
Provider Business Practice Location Address Fax Number:
305-279-3218
Provider Enumeration Date:
07/13/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 2086S0129X , with the licence number:  ME40910 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 2086S0129X , with the licence number: ME0040310 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 042544301 , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 008528700 . This is a "Florida Medicaid Provider ID" identifier , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".




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