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General NPI Number Information
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NPI Number | 1124227319
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Entity Type | Individual
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Provider Name | SAMANTHA KALAKURTHY MD
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Gender | Female
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Dates
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Enumeration Date | 07/17/2007
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Last Update Date | 08/22/2018
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Provider Practice Location Address
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Address Line | 1921 WALDEMERE ST STE 306
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City | SARASOTA
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State | FL
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Zip | 34239
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Country | US
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Telephone | 913-283-8063
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Fax | 913-238-8854
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Provider Business Mailing Address
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Address Line | 1921 WALDEMERE ST STE 306
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City | SARASOTA
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State | FL
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Zip | 34239-2941
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Country | US
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Telephone | 941-917-8722
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Fax | 941-917-8727
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RN0300X
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Taxonomy Name | Nephrology Physician
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License Number | 0433257
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License Number State | KS
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Taxonomy #2
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Taxonomy Code | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number | D0069457
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License Number State | MD
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Taxonomy #3
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Taxonomy Code | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number | 0101256679
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License Number State | VA
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Taxonomy #4
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 207RN0300X
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Taxonomy Name | Nephrology Physician
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License Number | ME133567
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License Number State | FL
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