Healthcare Provider Details

I. General information

NPI: 1295116176
Provider Name (Legal Business Name): KAIA CALBECK, PH.D. PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/16/2015
Last Update Date: 06/16/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7600 S RED RD STE 229
SOUTH MIAMI FL
33143-5428
US

IV. Provider business mailing address

3777 ROYAL PALM AVE
MIAMI BEACH FL
33140-3941
US

V. Phone/Fax

Practice location:
  • Phone: 305-669-4455
  • Fax: 305-665-5899
Mailing address:
  • Phone: 786-683-5100
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number6924
License Number StateFL

VIII. Authorized Official

Name: DR. KAIA BETH CALBECK
Title or Position: PSYCHOLOGIST
Credential: PH.D.
Phone: 786-683-5100