Provider Demographics
NPI:1144472614
Name:EQUBAL KALANI MD PA
Entity type:Organization
Organization Name:EQUBAL KALANI MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:AFROSE
Authorized Official - Middle Name:
Authorized Official - Last Name:KALANI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:727-943-2880
Mailing Address - Street 1:1501 S PINELLAS AVE
Mailing Address - Street 2:SUITE S
Mailing Address - City:TARPON SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:34689-1955
Mailing Address - Country:US
Mailing Address - Phone:727-943-2880
Mailing Address - Fax:727-943-2878
Practice Address - Street 1:1501 S PINELLAS AVE
Practice Address - Street 2:SUITE S
Practice Address - City:TARPON SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:34689-1955
Practice Address - Country:US
Practice Address - Phone:727-943-2880
Practice Address - Fax:727-943-2878
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-16
Last Update Date:2019-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL251159200Medicaid
FL251159200Medicaid