MEDICARE: DR. ISAAC KALVARIA 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	207RG0100X	Gastroenterology Physician	ME50532	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	ME50532	OTHER	FL	ME#

General Provider Information

NPI Number	:	1821082330
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ISAAC KALVARIA M.D.

Provider Business Mailing Address
First Line	:	1801 ARLINGTON ST
Second Line	:	SUITE 101
City	:	SARASOTA
State	:	FL
Zip	:	34239-3502
Country	:	US
Telephone Number	:	941-894-3490
Fax Number	:	941-870-7896

Provider Business Practice Location Address
First Line	:	1801 ARLINGTON ST
Second Line	:	SUITE 101
City	:	SARASOTA
State	:	FL
Zip	:	34239-3502
Country	:	US
Telephone Number	:	941-894-3490
Fax Number	:	941-870-7896

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

Provider Enumeration Date	:	09/12/2005
Last Update Date	:	04/22/2013

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