MEDICARE: DAVID M MCKALIP MD PA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207T00000X	Neurological Surgery Physician	ME81052	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	217481	OTHER	FL	AMERIGROUP
2	2490288	OTHER	FL	AETNA HMO
3	7373130	OTHER	FL	CIGNA
4	57962	OTHER	FL	BCBS
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
6	5790719	OTHER	FL	AETNA MANAGED CARE

General Provider Information

NPI Number	:	1194898346
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DAVID M MCKALIP MD PA

Provider Business Mailing Address
First Line	:	1955 1ST AVENUE NORTH
Second Line	:	SUITE 101
City	:	SAINT PETERSBURG
State	:	FL
Zip	:	33713-8907
Country	:	US
Telephone Number	:	727-822-3500
Fax Number	:	727-822-3228

Provider Business Practice Location Address
First Line	:	1955 1ST AVENUE NORTH
Second Line	:	SUITE 101
City	:	SAINT PETERSBURG
State	:	FL
Zip	:	33713-8907
Country	:	US
Telephone Number	:	727-822-3500
Fax Number	:	727-822-3228

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. DAVID MICHAEL MCKALIP
Credential	:	MD
Telephone Number	:	727-822-3500

Provider Enumeration Date	:	11/16/2006
Last Update Date	:	03/24/2015

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