MEDICARE: PAUL J KALIN

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	213ES0103X	Foot & Ankle Surgery Podiatrist

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1407150915
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PAUL J KALIN

Provider Business Mailing Address
First Line	:	1013 MAR WALT DR
Second Line	:	SUITE A
City	:	FORT WALTON BEACH
State	:	FL
Zip	:	32547-6723
Country	:	US
Telephone Number	:	850-863-1238
Fax Number	:	850-864-3338

Provider Business Practice Location Address
First Line	:	1013 MAR WALT DR
Second Line	:	SUITE A
City	:	FORT WALTON BEACH
State	:	FL
Zip	:	32547-6723
Country	:	US
Telephone Number	:	850-863-1238
Fax Number	:	850-864-3338

Authorized Official
Title or Position	:	CEO
Name	:	PAUL J KALIN
Credential	:
Telephone Number	:	850-863-1238

Provider Enumeration Date	:	12/28/2010
Last Update Date	:	12/28/2010

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