Provider Demographics
NPI:1265020002
Name:KALEM, ANGELA T (DNP, APRN)
Entity Type:Individual
Prefix:DR
First Name:ANGELA
Middle Name:T
Last Name:KALEM
Suffix:
Gender:F
Credentials:DNP, APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2055 REYKO RD STE 100
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32207-2822
Mailing Address - Country:US
Mailing Address - Phone:904-648-8200
Mailing Address - Fax:904-253-3270
Practice Address - Street 1:2055 REYKO RD STE 100
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32207-2822
Practice Address - Country:US
Practice Address - Phone:904-648-8200
Practice Address - Fax:904-253-3270
Is Sole Proprietor?:No
Enumeration Date:2021-01-07
Last Update Date:2022-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN92784082084P0800X
FLAPRN11011339363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry