Healthcare Provider Details

I. General information

NPI: 1114106754
Provider Name (Legal Business Name): LAWRENCE J KALES D P M P A
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/31/2007
Last Update Date: 11/03/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5327 SPRING HILL DR
SPRING HILL FL
34606-4558
US

IV. Provider business mailing address

5327 SPRING HILL DR
SPRING HILL FL
34606-4558
US

V. Phone/Fax

Practice location:
  • Phone: 352-683-5799
  • Fax:
Mailing address:
  • Phone: 352-683-5799
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License NumberPO 1074
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number
License Number StateFL

VIII. Authorized Official

Name: DR. LAWRENCE J KALES
Title or Position: PRESIDENT
Credential: D P M P A
Phone: 727-868-2128