| Kala Medical, Corp. | |
|
900 Sw 97th Ave Miami FL 33174-2935 | |
| (786) 507-5530 | |
| (786) 398-4641 |
| Full Name | Kala Medical, Corp. |
|---|---|
| Speciality | Internal Medicine |
| Location | 900 Sw 97th Ave, Miami, Florida |
| Authorized Official Name and Position | Alexangel Santana (PRESIDENT) |
| Authorized Official Contact | 3057537028 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Kala Medical, Corp. 900 Sw 97th Ave Miami FL 33174-2935 Ph: (786) 507-5530 | Kala Medical, Corp. 900 Sw 97th Ave Miami FL 33174-2935 Ph: (786) 507-5530 |
| NPI Number | 1053748517 |
|---|---|
| Provider Enumeration Date | 09/30/2013 |
| Last Update Date | 09/03/2021 |
| Medicare PECOS PAC ID | 8123255239 |
|---|---|
| Medicare Enrollment ID | O20131217001532 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053748517 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | ME103920 (Florida) | Primary |
| Provider Name | Alexangel Santana |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1578771697 PECOS PAC ID: 1658413109 Enrollment ID: I20100121000192 |
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