1013900588 NPI number — EQUBAL E KALANI MD

Table of content: EQUBAL E KALANI MD (NPI 1013900588)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1013900588 NPI number — EQUBAL E KALANI MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
KALANI
Provider First Name:
EQUBAL
Provider Middle Name:
E
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MD
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:
1013900588
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/20/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1501 S PINELLAS AVE
Provider Second Line Business Mailing Address:
SUITE S
Provider Business Mailing Address City Name:
TARPON SPRINGS
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
34689-1955
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
727-943-2880
Provider Business Mailing Address Fax Number:
727-943-2878

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1501 S PINELLAS AVE
Provider Second Line Business Practice Location Address:
SUITE S
Provider Business Practice Location Address City Name:
TARPON SPRINGS
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
34689-1955
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
727-943-2880
Provider Business Practice Location Address Fax Number:
727-943-2878
Provider Enumeration Date:
08/30/2005

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: 207RC0000X , with the licence number:  ME0070712 , 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: P00205783 . This is a "RR MCR" identifier . This identifiers is of the category "OTHER".
  • Identifier: 205231 . This is a "AVMED" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 190365 . This is a "WELLCARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 203758 . This is a "AMERIGROUP" identifier . This identifiers is of the category "OTHER".
  • Identifier: 5212260 . This is a "AETNA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 2101710 . This is a "GHI" identifier . This identifiers is of the category "OTHER".




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