MEDICARE: DANIEL G KALBAC 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	207X00000X	Orthopaedic Surgery Physician	ME58988	FL
2	207XX0005X	Sports Medicine (Orthopaedic Surgery) Physician	ME58988	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	ME58988	OTHER	FL	WORKERS COMPENSATION
2	000623	OTHER	FL	NEIGHBORHOOD HEALTH PLAN
3	209485	OTHER	FL	AVMED HEALTH PLAN
4	1237594	OTHER	FL	UNITED HEALTHCARE
5	4517471	OTHER	FL	AETNA
6	17697	OTHER	FL	BLUE SHIELD
7	591370925	OTHER	FL	CIGNA

General Provider Information

NPI Number	:	1699870634
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DANIEL G KALBAC MD

Provider Business Mailing Address
First Line	:	PO BOX 430430
Second Line	:
City	:	SOUTH MIAMI
State	:	FL
Zip	:	33243-0430
Country	:	US
Telephone Number	:	305-661-7601
Fax Number	:	305-661-0154

Provider Business Practice Location Address
First Line	:	6701 SUNSET DR
Second Line	:	SUITE 201
City	:	SOUTH MIAMI
State	:	FL
Zip	:	33143-4529
Country	:	US
Telephone Number	:	305-661-7601
Fax Number	:	305-661-0154

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

Provider Enumeration Date	:	09/14/2006
Last Update Date	:	10/31/2013

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Directions to “ DANIEL G KALBAC MD” Practice Location

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