Healthcare Provider Details

I. General information

NPI: 1437716198
Provider Name (Legal Business Name): BRANDON KALIVODA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/28/2019
Last Update Date: 09/03/2026
Certification Date: 09/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

350 7TH ST N
NAPLES FL
34102-5754
US

IV. Provider business mailing address

350 7TH ST N
NAPLES FL
34102-5754
US

V. Phone/Fax

Practice location:
  • Phone: 239-624-6400
  • Fax: 239-624-0401
Mailing address:
  • Phone: 239-624-6400
  • Fax: 239-624-0401

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License NumberME152560
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: