Individual
DR. MYLAN KALTMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PSY.D.
Contact information
Practice address
1350 S HICKORY ST, HOLMES REGIONAL MEDICAL CENTER, MELBOURNE, FL 32901-3224
(321) 434-1771
(321) 434-1775
Mailing address
PO BOX 561600, ROCKLEDGE, FL 32956-1600
(321) 434-4600
(321) 259-0635
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
PY7747
FL
103TC0700X
Clinical Psychologist
Primary
PY7747
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
75266
BLUE CROSS BLUE SHIELD OF FL
FL
Enumeration date
10/30/2008
Last updated
06/08/2012
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