Provider Demographics
NPI:1902807126
Name:KALER, BARRY A (DO)
Entity Type:Individual
Prefix:
First Name:BARRY
Middle Name:A
Last Name:KALER
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2751 SW GLENMOOR WAY
Mailing Address - Street 2:
Mailing Address - City:PALM CITY
Mailing Address - State:FL
Mailing Address - Zip Code:34990-7913
Mailing Address - Country:US
Mailing Address - Phone:772-219-1997
Mailing Address - Fax:
Practice Address - Street 1:2751 SW GLENMOOR WAY
Practice Address - Street 2:
Practice Address - City:PALM CITY
Practice Address - State:FL
Practice Address - Zip Code:34990-7913
Practice Address - Country:US
Practice Address - Phone:772-219-1997
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-08-10
Last Update Date:2008-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC9900266207Q00000X
FLOS5331207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC5909433Medicaid
NC5909433Medicaid
NC2022220Medicare PIN