MEDICARE: DR. KAISA M. VANDERKOOI M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207NS0135X	Procedural Dermatology Physician	4301086274	MI
2	207ND0900X	Dermatopathology Physician	4301086274	MI
3	207N00000X	Dermatology Physician	ME109089	FL

General Provider Information

NPI Number	:	1427269885
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KAISA M. VANDERKOOI M.D.

Provider Business Mailing Address
First Line	:	2505 HARRISON AVE
Second Line	:
City	:	PANAMA CITY
State	:	FL
Zip	:	32405-4464
Country	:	US
Telephone Number	:	850-233-3376
Fax Number	:	850-522-8354

Provider Business Practice Location Address
First Line	:	1474 MARKET ST
Second Line	:
City	:	TALLAHASSEE
State	:	FL
Zip	:	32312-1768
Country	:	US
Telephone Number	:	850-233-3376
Fax Number	:	850-522-8354

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/25/2007
Last Update Date	:	03/04/2026

Similar Medicare Providers

1730568601 — MRS. ELIZABETH HANDLEY MILLER ARNP
Practice Location Address:

1474 MARKET ST
TALLAHASSEE, FL
32312-1768

Practice Phone: 850-233-3376
Practice Fax: 850-522-8354

1427081496 — DR. IRA FREILICH MD
Practice Location Address:

1474 MARKET ST
TALLAHASSEE, FL
32312-1768

Practice Phone: 850-233-3376
Practice Fax: 850-522-8354

1134779770 — KATHERINE SZAKAL BRIDGES PA
Practice Location Address:

1474 MARKET ST
TALLAHASSEE, FL
32312-1768

Practice Phone: 850-233-3376
Practice Fax: 850-522-8354

1831621762 — DR. KATHRYN MARIE GAVALAS DMD
Practice Location Address:

1280 TIMBERLANE RD
TALLAHASSEE, FL
32312-1710

Practice Phone: 561-315-7091
Practice Fax:

1568208007 — DR. BLAKE CAMERON GARFINKEL DDS
Practice Location Address:

1280 TIMBERLANE RD
TALLAHASSEE, FL
32312-1710

Practice Phone: 850-893-2136
Practice Fax:

1912958810 — DR. TOM RIFAI MD
Practice Location Address:

1264 METROPOLITAN BLVD
TALLAHASSEE, FL
32312-2536

Practice Phone: 850-383-3333
Practice Fax:

Directions to “ DR. KAISA M. VANDERKOOI M.D.” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.