Provider Demographics
NPI:1083120943
Name:KALMAN, MICHAEL JONATHAN
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:JONATHAN
Last Name:KALMAN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:815 PARK HARBOUR DR
Mailing Address - Street 2:
Mailing Address - City:BOARDMAN
Mailing Address - State:OH
Mailing Address - Zip Code:44512-3973
Mailing Address - Country:US
Mailing Address - Phone:330-423-2500
Mailing Address - Fax:
Practice Address - Street 1:1200 7TH AVE N
Practice Address - Street 2:
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33705-1300
Practice Address - Country:US
Practice Address - Phone:813-350-7244
Practice Address - Fax:813-350-7246
Is Sole Proprietor?:No
Enumeration Date:2017-12-14
Last Update Date:2023-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN.375278163W00000X
FLRN9489017163W00000X
FLAPRN9489017367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
No163W00000XNursing Service ProvidersRegistered Nurse