Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NI0013X | Independent Medical Examiner | CH11179 | FL |
NPI | 1982024410 |
---|---|
Provider Name | Dr. Paul Kalloghlian |
First Address | St Petersburg, FL 33701 |
Second Address | St Petersburg, FL 33701 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/04/2014 |
Last Update Date | 23/04/2014 |