Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 35.131530 | OH |
N | 111NI0900X | Internist | 35.131530 | OH |
N | 207RH0002X | Hospice and Palliative Medicine | 35.131530 | OH |
Y | 207RH0002X | Hospice and Palliative Medicine | ME138572 | FL |
NPI | 1134539307 |
---|---|
Provider Name | Dr. Perry Michael Kalis II |
First Address | Pensacola, FL 32522-7668 |
Second Address | Pensacola, FL 32501-2316 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/04/2014 |
Last Update Date | 31/10/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
101573800 | (05) | FL |