Provider Demographics
NPI:1073503868
Name:CALAMIA, KENNETH TEMPLE (MD)
Entity Type:Individual
Prefix:
First Name:KENNETH
Middle Name:TEMPLE
Last Name:CALAMIA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:110 CUELLO CT UNIT 102
Mailing Address - Street 2:
Mailing Address - City:PONTE VEDRA BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32082-4091
Mailing Address - Country:US
Mailing Address - Phone:904-881-9829
Mailing Address - Fax:
Practice Address - Street 1:126 NORTHPORT AVE
Practice Address - Street 2:SUITE 106
Practice Address - City:BELFAST
Practice Address - State:ME
Practice Address - Zip Code:04915
Practice Address - Country:US
Practice Address - Phone:207-505-4015
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-10-24
Last Update Date:2023-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME78510207RR0500X
MEMD24851207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL10668OtherBLUECROSS/BLUESHIELD
FL10668ZMedicare UPIN
FL700005976OtherRAILROAD MEDICARE
FL279734800Medicaid