Provider Demographics
NPI:1588799712
Name:KANTER, GARY LAWRENCE (MD)
Entity type:Individual
Prefix:MR
First Name:GARY
Middle Name:LAWRENCE
Last Name:KANTER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 100256
Mailing Address - Street 2:SUITE B
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32610-0256
Mailing Address - Country:US
Mailing Address - Phone:352-392-3681
Mailing Address - Fax:352-846-1455
Practice Address - Street 1:108 NW 76TH DRIVE
Practice Address - Street 2:SUITE B
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32607-6652
Practice Address - Country:US
Practice Address - Phone:352-332-1300
Practice Address - Fax:352-332-1346
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-21
Last Update Date:2016-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME424482084P0800X, 2084P0805X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0805XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyGeriatric Psychiatry
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL017308500Medicaid
FLIO632ZMedicare PIN