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NPI Code Detail

MEDICARE: DR. CORI J. CALKINS PSY.D.

MEDICARE:  DR. CORI J. CALKINS  PSY.D.
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
1103TC0700XClinical PsychologistPY6814FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
174376OTHERFLBCBS INDIVID. PROVIDER #
274976OTHERFLBCBS GROUP PROVIDER #

General Provider Information

NPI Number : 1740372325
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. CORI J. CALKINS PSY.D.
Provider Business Mailing Address
First Line : 12801 EAGLE POINTE CIR
Second Line :
City : FORT MYERS
State : FL
Zip : 33913-7964
Country : US
Telephone Number : 239-418-1899
Fax Number :
Provider Business Practice Location Address
First Line : 6150 DIAMOND CENTRE CT UNIT 1003
Second Line :
City : FORT MYERS
State : FL
Zip : 33912-7135
Country : US
Telephone Number : 239-561-9955
Fax Number : 239-561-9779
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/29/2006
Last Update Date : 07/08/2007

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