MEDICARE: CRYSTAL LYNN KALEN

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	207Q00000X	Family Medicine Physician	F04260165	FL

General Provider Information

NPI Number	:	1922941442
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CRYSTAL LYNN KALEN

Provider Business Mailing Address
First Line	:	1431 SW 1ST TER
Second Line	:
City	:	CAPE CORAL
State	:	FL
Zip	:	33991-1402
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1431 SW 1ST TER
Second Line	:
City	:	CAPE CORAL
State	:	FL
Zip	:	33991-1402
Country	:	US
Telephone Number	:	812-242-0315
Fax Number	:

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

Provider Enumeration Date	:	04/10/2026
Last Update Date	:	04/10/2026

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Directions to “ CRYSTAL LYNN KALEN ” Practice Location

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