Healthcare Provider Details

I. General information

NPI: 1013900588
Provider Name (Legal Business Name): EQUBAL E KALANI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/30/2005
Last Update Date: 02/20/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1501 S PINELLAS AVE SUITE S
TARPON SPRINGS FL
34689-1955
US

IV. Provider business mailing address

1501 S PINELLAS AVE SUITE S
TARPON SPRINGS FL
34689-1955
US

V. Phone/Fax

Practice location:
  • Phone: 727-943-2880
  • Fax: 727-943-2878
Mailing address:
  • Phone: 727-943-2880
  • Fax: 727-943-2878

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License NumberME0070712
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: