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NPI Code Detail

MEDICARE: JOHN KALOGRIS

MEDICARE: JOHN KALOGRIS
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
1171M00000XCase Manager/Care Coordinator

Other Identifiers

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

General Provider Information

NPI Number : 1457782294
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOHN KALOGRIS
Provider Business Mailing Address
First Line : 1745 POINTE WEST WAY
Second Line :
City : VERO BEACH
State : FL
Zip : 32966-2448
Country : US
Telephone Number : 772-801-8505
Fax Number :
Provider Business Practice Location Address
First Line : 247 SW PORT ST LUCIE BLVD
Second Line :
City : PORT SAINT LUCIE
State : FL
Zip : 34984-5015
Country : US
Telephone Number : 772-837-7989
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/04/2013
Last Update Date : 04/12/2021

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