Healthcare Provider Details

I. General information

NPI: 1457654113
Provider Name (Legal Business Name): LORENC KALAVESHI D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/17/2010
Last Update Date: 08/28/2023
Certification Date: 08/28/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1717 S ORANGE AVE STE 103
ORLANDO FL
32806-2946
US

IV. Provider business mailing address

1717 S ORANGE AVE STE 103
ORLANDO FL
32806-2946
US

V. Phone/Fax

Practice location:
  • Phone: 321-841-4344
  • Fax:
Mailing address:
  • Phone: 321-841-4344
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberA-1907-15
License Number StateNM
# 2
Primary TaxonomyN
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License NumberA-1907-15
License Number StateNM
# 3
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License NumberOS11691
License Number StateFL
# 4
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License NumberOS11691
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: