MEDICARE: AYESHA KALEEM MD

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	207RN0300X	Nephrology Physician	ME79639	FL

General Provider Information

NPI Number	:	1376618645
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AYESHA KALEEM MD

Provider Business Mailing Address
First Line	:	4423 NW 6TH PLACE
Second Line	:	SUITE A
City	:	GAINESVILLE
State	:	FL
Zip	:	32607-6115
Country	:	US
Telephone Number	:	352-377-5600
Fax Number	:	352-377-0995

Provider Business Practice Location Address
First Line	:	4423 NW 6TH PL STE A
Second Line	:	SUITE A
City	:	GAINESVILLE
State	:	FL
Zip	:	32607-6116
Country	:	US
Telephone Number	:	352-377-5600
Fax Number	:	352-377-0995

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/22/2006
Last Update Date	:	07/08/2007

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