Healthcare Provider Details

I. General information

NPI: 1083146005
Provider Name (Legal Business Name): AMARDEEP KAUR KALSI M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/29/2017
Last Update Date: 03/30/2025
Certification Date: 03/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2100 GLENWOOD DR
WINTER PARK FL
32792-3308
US

IV. Provider business mailing address

2100 GLENWOOD DR STE 102
WINTER PARK FL
32792-3308
US

V. Phone/Fax

Practice location:
  • Phone: 407-821-3566
  • Fax: 407-821-3568
Mailing address:
  • Phone: 407-821-3567
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RX0202X
TaxonomyMedical Oncology Physician
License NumberME168467
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: